Update on the History and Physical Evaluation of a Failed Back Surgery Syndrome

Failed back surgery syndrome (FBSS) is a diagnosis given to patients who complain of pain symptoms after unsuccessful lumbar surgery. Many FBSS patients present for more surgery and an understanding of the common causes of FBSS can help devise a treatment plan. Common identifiable causes for FBSS include poor patient selection, incorrect initial diagnosis, incorrect or inadequate surgery, scarring, infection, and progressive disease. A complete review of the patient's history, physical exam, and all necessary radiological and diagnostic studies will lead to a diagnosis in the majority of the cases.