• The Korean Journal of Pain
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• 제37권1호
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• pp.73-83
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• 2024

Background: Failed back surgery syndrome (FBSS) is a chronic condition that is characterized by persistent back pain following one or more spinal surgeries. Pharmacological interventions, such as the use of opioids and gabapentinoids, are frequently used in the treatment of FBSS. However, prolonged and excessive use of these medications can lead to dependence and adverse effects. This study investigates trends in opioid and gabapentinoid prescriptions among patients with FBSS in Korea from 2016 to 2020. Methods: Data from the Health Insurance and Review Agency were analyzed, and claims listing FBSS were selected for the study. Prescription patterns of opioids and gabapentinoids were classified based on the number of days prescribed per year. Results: Of the 390,095 patients diagnosed with FBSS, 41.6% of the patients were prescribed gabapentinoids, and 42.0% of them were prescribed opioids, while 10.6% of the patients were classified as long-term gabapentinoid users, 11.4% as long-term opioid users, and 7.4% of the patients were found to have long-term prescriptions for both drugs. The proportion of patients who received both gabapentinoid and opioid prescriptions increased annually. The doses of opioids prescribed have also increased along with the increase in the number of patients receiving opioid prescriptions. Conclusions: The prescription rates of opioids and gabapentinoids among patients with FBSS in Korea continue to increase steadily, posing potential risks of addiction and adverse effects. Further research is needed to better understand the actual status of addiction in patients with FBSS.

• 대한한방내과학회지
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• 제40권1호
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• pp.126-135
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• 2019

Background: Because of fear of reoperation and low efficiency, some patients with failed back surgery syndrome (FBSS) opt for Korean medicine treatment. Gold standard treatment is not present for FBSS, therefore both surgical and non-surgical treatment are possible. Studies of Korean conservative medicine for FBSS had a short duration of treatment and mainly pre- and post-treatment comparisons. And case of female patients who have worsened after childbirth is rare. The purpose of this study was to report long-term follow-up and rare cases of FBSS. Case summary: A 33-year-old female patient diagnosed with lumbar disc herniation complained with low back pain and radicular pain in the left leg after surgery in 2011. Acupuncture and decoction (Cheongpa-jeon, GCSB-5) were administered to her twice a day for about 6 years and 6 months. The patient's complaints improved with each hospitalization, and Magnetic Resonance Imaging (MRI) showed a slight decrease in the size of the recurrent disc (L4/5) and a newly developed disc (L5/S1) that had deteriorated after delivery. Conclusion: Korean medicine could be used to manage the pain of lumbar spine FBSS patients for 6-7 years and to alleviate lumbago after delivery.

• 척추신경추나의학회지
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• 제13권2호
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• pp.65-73
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• 2018

Objectives : To verify Korean Medicinal Combination Treatments for patients who have Failed Back Surgery Syndrome along with scoliosis Methods : We used Acupuncture, Chuna manual therapy, Pharmacoacupuncture, Herbal medication. We measured Numeral Rating Sacle(NRS), Pain-Free walking distance(PFWD) and Oswestry Disability Index(ODI) score to evaluate the treatment effects. Results : Patients' LBP & Rt.leg pain NRS, PFWD and ODI score were improved. Conclusions : Traditional Korean medicine can be effective for FBSS patients along with scoliosis.

• The Korean Journal of Pain
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• 제20권2호
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• pp.199-202
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• 2007

Failed back surgery syndrome (FBSS) is a condition characterized by extreme pain after spinal surgery. Treatment of FBSS is aimed at improving function, using interdisciplinary approaches that encompass rehabilitation, psychological therapy, and pain management. If no response to conventional treatment is noted, a more interventional technique such as spinal cord stimulation (SCS) should be used. SCS is a well-established method of managing a variety of chronic neuropathic pain conditions. A 32 year-old male patient afflicted by FBSS that was irresponsive to both medication and several repeated nerve blocks showed improvement of symptoms after cervical and thoracic SCS with a single electrode. Centered on the midline of the spinal cord, single-electrode SCS can be an effective method for relieving pain and improving function.

• 척추신경추나의학회지
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• 제17권2호
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• pp.1-15
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• 2022

Objectives This study aimed to assess the efficacy and safety of manual therapy in patients with failed back surgery syndrome (FBSS). Methods We searched eight electronic databases from October 2022 and only selected randomized controlled trials (RCTs) reporting outcomes for manual therapy in FBSS patients. Included studies were analyzed qualitatively. Results A total of twelve RCTs were included and three studies were meta-analyzed. Manual therapy combined with exercise demonstrated more favorable outcomes in terms of pain reduction compared to exercise therapy only (P<0.01). Some studies reported that manual therapy resulted in low efficacy, while some studies reported that specific manual techniques have a significant effect in pain relief. We, therefore, conclude that several studies have a high risk of bias. Conclusions Findings suggest that manual therapy is a safe and non-invasive, promising option for managing FBSS. However, manual therapy is not the best option in all circumstances; thus, this should be selectively applied by a well-trained practitioner. Further studies such as well-designed, risk-controlled RCTs are required to gain stronger evidence.

• 한방재활의학과학회지
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• 제24권4호
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• pp.41-48
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• 2014

Objectives The present study examines the domestic trend of Failed Back Surgery Syndrome (FBSS) in Korea. Methods The studies on FBSS were investigated via searching Korean web databases. As a result, 41 research papers were found and they were analyzed according to the year of publishment, the titles of journals which have the papers, the types of study, the definition of FBSS, employed treatment trials, and the instruments for assessment. Results The number of the research papers on FBSS published was increased since 2005. The studies on FBSS were mainly published in the Korean Journal of Pain. The most popular type of the studies were the case report and the most studies defined FBSS as persistent or recurring low back pain with or without sciatica after receiving spine surgeries. Various surgical and conservative treatments were employed in the studies and Visual Analogue Scale (VAS), Numeric Rating Scale (NRS), Oswestry Disability Index (ODI) were used as primary means of assessments. Conclusions Reviewing the domestic trends of studies on FBSS and examining the definition of FBSS is essential for the future studies because there is no clear criteria for making diagnosis of FBSS. Therefore, the further studies on FBSS need to be more elaborate with the definition of FBSS, and it is also necessary to apply more assessment tools for the better understanding of FBSS from various aspects. Ultimately, this review is anticipated to benefit the future in-depth study on FBSS.

• 척추신경추나의학회지
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• 제6권2호
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• pp.23-32
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• 2011

본 논문은 3차례의 양방적 수술 치료를 받은 후에도 지속적으로 요통과 함께 하지 방사통을 호소하며 일상생활 수행에 장애가 따르던 70세 여환에 대한 증례로 침구치료, 약물치료, 추나치료, 봉약침치료 등의 한의학적 보존적 치료방법으로 통증의 감소와 함께 일상생활 능력 개선에 유의한 효과를 보였다. 향후 요추 추간판 탈출증 환자의 한방적 보존적 치료에 대한 보다 다양한 연구와 임상적 고찰이 이루어져야 한다고 사료된다.

• Journal of Korean Neurosurgical Society
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• 제54권6호
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• pp.501-506
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• 2013

Objective : Spinal cord stimulation (SCS) is an effective means of treatment of chronic neuropathic pain from failed back surgery syndrome (FBSS). Because the success of trial stimulation is an essential part of SCS, we investigated factors associated with success of trial stimulation. Methods : Successful trial stimulation was possible in 26 of 44 patients (63.6%) who underwent insertion of electrodes for the treatment of chronic pain from FBSS. To investigate factors associated with successful trial stimulation, patients were classified into two groups (success and failure in trial). We investigated the following factors : age, sex, predominant pain areas (axial, limb, axial combined with limbs), number of operations, duration of preoperative pain, type of electrode (cylindrical/paddle), predominant type of pain (nociceptive, neuropathic, mixed), degree of sensory loss in painful areas, presence of motor weakness, and preoperative Visual Analogue Scale. Results : There were no significant differences between the two groups in terms of age, degree of pain, number of operations, and duration of pain (p>0.05). Univariate analysis revealed that the type of electrode and presence of severe sensory deficits were significantly associated with the success of trial stimulation (p<0.05). However, the remaining variable, sex, type of pain, main location of pain, degree of pain duration, degree of sensory loss, and presence of motor weakness, were not associated with the trial success of SCS for FBSS. Conclusion : Trial stimulation with paddle leads was more successful. If severe sensory deficits occur in the painful dermatomes in FBSS, trial stimulation were less effective.

• 대한한의학회지
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• 제37권2호
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• pp.93-103
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• 2016

Objectives: The purpose of this study was to report Four cases of Failed Back Surgery Syndrome (FBSS) patients after spinal fusion surgery who showed significant improvement in pain and function with Complex Korean medical treatment. Methods: This study was a retrospective observational study. We reviewed medical records of Four patients with lumbar pain or radiating leg pain, who have received spinal fusion surgery in the past. All Four patients took complex treatments of Mokhuri Neck and Back hospital which involes Acupuncture, Pharmaco-acupuncture, Gangchuk herbal medicine, Chuna and Physical therapy during about four-week of admission treatment. Visual Analogue Scale (VAS), Oswestry disability index (ODI), Pain Free Walking Distance (PFWD) scores were assessed before and after treatments. Results: The average of hospitalization period was 28.5 days. Mean VAS scores decreased from 6.5 to 2.3, Oswestry Disability Index (ODI) scores decreased from 56.25 to 38.25 and Pain Free Walking Distance (PFWD) also improved from 10m to 166.6m. Conclusion: This study implies that a combination of Korean medical treatments might be effective in relieving pain, and improving the functional status of FBSS patients. Further studies are needed to fully understand the mechanisms underlying the effects.

• Journal of Acupuncture Research
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• 제28권5호
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• pp.77-86
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• 2011

Objective : This study was designed to evaluate the effect of bee venom pharmacopuncture therapy in patients with FBSS(failed back surgery syndrome). Methods : We investigated 30 cases of patients with FBSS, who had been treated from October 2010 to July 2011. We divided patients into two groups : group I was treated by acupuncture therapy only, and group II was treated by bee venom pharmacopuncture therapy and general acupuncture. We measured the efficacy of treatments using the numerical rating scale(NRS) and grade and straight leg raising(SLR) test. Results : 1. The treatment method for group II was more effective than that of group I in reducing the NRS score on the fifteenth day after admission but there was no statistically significant difference between the results of two groups on the fifth day after admission and the tenth day after admission. 2. The treatment method for group II was more effective than that of group I in NRS improvement rate from its admission day to the fifth day after admission and from the tenth day after admission to the fifteenth day after admission but there was no statistically significant difference between the performance of two groups from the fifth day after admission to the tenth day after admission. 3. Group II had a higher grade improvement rate from the seventh day after admission to the fifteenth day after admission than group I but no statistically significant difference was observed between the results of two groups from its admission day to the seventh day after admission. 4. In SLR test improvement rate the treatments applied to group II was more effective than those applied to group I. Conclusion : The results of this study suggest that bee venom pharmacopuncture therapy is effective in reducing pain for patients with FBSS. Further clinical research is needed to verify these results and findings.