Prevalence, characteristics, and burden of failed back surgery syndrome: the influence of various residual symptoms on patient satisfaction and quality of life as assessed by a nationwide internet survey in Japan
Open accessAbstract
Abstract: We conducted a cross-sectional, Internet-based survey with a nationally representative sample of Japanese adults to assess the prevalence and characteristics of failed back surgery syndrome (FBSS). Data regarding the residual symptoms and patient satisfaction from an online survey of 1842 lumbar surgery patients revealed the prevalence of FBSS to be 20.6% (95% confidence interval [CI], 18.8–22.6). The prevalence of low back pain, dull ache, numbness, cold sensations, and paresthesia after surgery was 94.0%, 71.1%, 69.8%, 43.3%, and 35.3%, respectively. With a logistic regression model, severe residual low back pain (numerical rating scale 8–10), higher pain intensity, and multiple low back surgeries were strongly associated with FBSS, with odds ratios of 15.21 (95% CI, 7.79–29.7), 1.40 (95% CI, 1.32–1.49), and 1.87 (95% CI, 1.25–2.81), respectively. Respondents with FBSS had significantly lower EuroQol-5D ( P <0.001) values and significantly higher scores on the Kessler six-item psychological distress scale ( P <0.001), compared with the non-FBSS group. Our findings indicate that residual sensations have a significant effect on patient quality of life, similar to that of chronic low back pain. Precise presurgical provision of prognoses based on comprehensive epidemiologic data, as well as scrupulous attention to patient satisfaction and clinical progress may help reduce the incidence of FBSS. Keywords: failed back surgery syndrome, patient satisfaction, prevalence, residual symptom, numbness
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About 20-30% of spinal surgery patients do not experience long-term improvement in pain relief after surgery.
“In addition, about 20–30% of spinal surgery patients do not experience (long-term) improvement in pain relief after surgery”
From Strength Back – A qualitative study on the co-creation of a positive psychology digital health intervention for spinal surgery patients (2023) · cites this paper as Inoue et al., 2017
The Results (Prevalence of FBSS; page not provided) report a 20.6% rate of failed back surgery syndrome, measured an average of 3.4 years after low-back surgery. But the paper defines that outcome as dissatisfaction plus at least one unpleasant residual sensation, not a lack of improvement in pain relief. It therefore does not establish that 20–30% experienced no long-term pain improvement. (LLM, conf=0.86)
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- Authors
- Inoue, S., Kamiya, M., Nishihara, M., Arai, Y.-C. P., Ikemoto, T., & Ushida, T.
- Affiliations
- Aichi Medical University (JP)
- Corresponding author
- Inoue, Shinsuke
- Venue
- Journal of Pain Research
- Publisher
- Informa UK Limited
- Published
- 2017-04
- Volume
- Volume 10
- Pages
- 811-823
- ISSN
- 1178-7090 (ISSN-L)
- PMC
- PMC5388346
- OpenAlex
- W2605205719
- Cited by
- 84
- References
- 33
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 12 · 2023: 17 · 2022: 9 · 2021: 8 · 2020: 6 · 2019: 7 · 2018: 3 · 2017: 1
- FWCI
- 3.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Pain Research (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Funders
- Ministry of Health, Labour and Welfare
- Japan Society for the Promotion of Science (16K10262)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Keywords
- failed back surgery syndrome, lumbar spine surgery, numbness, paresthesia, patient satisfaction, quality of life, psychological distress, prevalence, Japan
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