Failed back surgery syndrome

Failed back surgery syndrome or FBSS is pain that persists after spinal surgery or pain that is new as a result of spinal surgery. Wound pain immediately after back surgery or pain in the first days and weeks after surgery do not belong to this chronic back pain.

What causes failed back surgery syndrome?

Patients who develop FBSS have had one or more back surgeries due to back and/or leg pain. Despite back surgery, 10–40 % of those operated on still suffer pain afterwards. Where the pain comes from is usually unknown.

In the last 20 years, the number of back operations has increased rapidly. With each additional back surgery, the success rate decreases:

    70–90 % after the first surgery
    30 % after the second operation
    15 % after the third operation
    5 % after the fourth operation

The longer patients suffer from failed back surgery syndrome, the more difficult it is to treat. Complicating the chronic back pain can be stress, decreased self-esteem, unemployment, financial problems, and depression. The level of suffering from failed back surgery syndrome is comparable to chronic heart failure or cancer.

How can failed back surgery syndrome be treated?

FBSS can be treated conservatively, interventional or with neuromodulation. At our clinic, patients who have a long history of suffering are examined on an interdisciplinary basis in order to be able to offer them a therapy tailored to their needs.

Conservative therapy

The most important therapeutic approach is to train the muscles. Physiotherapy can help with this, combined with painkillers or psychosomatic pain therapy depending on the findings.

Interventional pain therapy

If conservative treatment of the pain is not effective, methods of interventional pain therapy can be used. These include targeted infiltration, targeted current therapy with radio frequency (radio frequency ablation) or thermocoagulation, in which a cannula with a fine wire is guided directly to the pain-conducting nerve structure in a minimally invasive manner and the nerve fiber is specifically obliterated.


Neuromodulation affects the transmission of nerve impulses through current or through medication. If conservative therapies for failed back surgery syndrome do not bring improvement, spinal cord stimulation can be performed or a drug pump can be used.