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Pain Research and Management
Volume 2019, Article ID 8184592, 12 pages
Review Article

Optimizing the Management and Outcomes of Failed Back Surgery Syndrome: A Proposal of a Standardized Multidisciplinary Team Care Pathway

1Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
2Department of Pain and Anaesthesia, The James Cook University Hospital, Middlesbrough, UK
3Spine & Neuromodulation Functional Unit, Poitiers University Hospital, Poitiers, France
4Institut Pprime UPR 3346, CNRS, University of Poitiers, Poitiers, ISAE-ENSMA, France
5PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, Poitiers, France
6Department of Neurosurgery, Jessa Hospital, Hasselt, Belgium
7Department of Anesthesia and Pain Management, Hospital AZ Nikolaas, Sint-Niklaas, Belgium

Correspondence should be addressed to Philippe Rigoard; rf.sreitiop-uhc@draogir.eppilihp

Received 19 December 2018; Revised 29 April 2019; Accepted 27 June 2019; Published 8 July 2019

Guest Editor: Baogan Peng

Copyright © 2019 Kliment Gatzinsky et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Failed back surgery syndrome (FBSS) is a major, worldwide health problem that generates considerable expense for healthcare systems. A number of controversial issues concerning the management of FBSS are regularly debated, but no clear consensus has been reached. This pitfall is the result of lack of a standardized care pathway due to insufficient characterization of underlying pathophysiological mechanisms, which are essential to identify in order to offer appropriate treatment, and the paucity of evidence of treatment outcomes. In an attempt to address the challenges and barriers in the clinical management of FBSS, an international panel of physicians with a special interest in FBSS established the Chronic Back and Leg Pain (CBLP) Network with the primary intention to provide recommendations through consensus on how to optimize outcomes. In the first of a series of two papers, a definition of FBSS was delineated with specification of criteria for patient assessment and identification of appropriate evaluation tools in order to choose the right treatment options. In this second paper, we present a proposal of a standardized care pathway aiming to guide clinicians in their decision-making on how to optimize their management of FBSS patients. The utilization of a multidisciplinary approach is emphasized to ensure that care is provided in a uniform manner to reduce variation in practice and improve patient outcomes.