1
|
Christelis N, Simpson B, Russo M, Stanton-Hicks M, Barolat G, Thomson S, Schug S, Baron R, Buchser E, Carr DB, Deer TR, Dones I, Eldabe S, Gallagher R, Huygen F, Kloth D, Levy R, North R, Perruchoud C, Petersen E, Rigoard P, Slavin K, Turk D, Wetzel T, Loeser J. Persistent Spinal Pain Syndrome: A Proposal for Failed Back Surgery Syndrome and ICD-11. Pain Med 2021; 22:807-818. [PMID: 33779730 PMCID: PMC8058770 DOI: 10.1093/pm/pnab015] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective For many medical professionals dealing with patients with persistent pain following spine surgery, the term Failed back surgery syndrome (FBSS) as a diagnostic label is inadequate, misleading, and potentially troublesome. It misrepresents causation. Alternative terms have been suggested, but none has replaced FBSS. The International Association for the Study of Pain (IASP) published a revised classification of chronic pain, as part of the new International Classification of Diseases (ICD-11), which has been accepted by the World Health Organization (WHO). This includes the term Chronic pain after spinal surgery (CPSS), which is suggested as a replacement for FBSS. Methods This article provides arguments and rationale for a replacement definition. In order to propose a broadly applicable yet more precise and clinically informative term, an international group of experts was established. Results 14 candidate replacement terms were considered and ranked. The application of agreed criteria reduced this to a shortlist of four. A preferred option—Persistent spinal pain syndrome—was selected by a structured workshop and Delphi process. We provide rationale for using Persistent spinal pain syndrome and a schema for its incorporation into ICD-11. We propose the adoption of this term would strengthen the new ICD-11 classification. Conclusions This project is important to those in the fields of pain management, spine surgery, and neuromodulation, as well as patients labeled with FBSS. Through a shift in perspective, it could facilitate the application of the new ICD-11 classification and allow clearer discussion among medical professionals, industry, funding organizations, academia, and the legal profession.
Collapse
Affiliation(s)
| | - Brian Simpson
- Department of Neurosurgery, University Hospital of Wales, Cardiff, UK
| | - Marc Russo
- Hunter Pain Specialists, Broadmeadow, New South Wales, Australia
| | | | | | - Simon Thomson
- Basildon and Thurrock University Hospitals, Basildon, UK
| | - Stephan Schug
- Anaesthesiology and Pain Medicine, Medical School, University of Western Australia and Royal Perth Hospital, Perth, Western Australia, Australia
| | - Ralf Baron
- Department of Neurology, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | | | - Daniel B Carr
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
| | | | - Ivano Dones
- Department of Neurosurgery, Fondazione Istituto Neurologico "C. Besta," Milano, Italy
| | - Sam Eldabe
- The James Cook University Hospital, Middlesbrough, UK
| | - Rollin Gallagher
- Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Frank Huygen
- Center for Pain Medicine, Erasmus MC Pijnbehandelcentrum, Rotterdam, Zuid-Holland, Netherlands
| | - David Kloth
- Department of Anesthesiology, Danbury Hospital, Danbury, Connecticut, USA
| | - Robert Levy
- Marcus Neuroscience Institute, Boca Raton, Florida, USA
| | - Richard North
- Department of Neurosurgery, Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Erika Petersen
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Philippe Rigoard
- Spine-Neurostimulation Functional Unit, PRISMATICS, Poitiers Hospital University, Poitiers, France
| | - Konstantin Slavin
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Dennis Turk
- University of Washington Seattle, Washington, USA
| | - Todd Wetzel
- Department of Orthopedics, Bassett Medical Center, Coopersown, New York, USA
| | - John Loeser
- Departments of Neurological Surgery & Anesthesiology & Pain Medicine, University of Washington, Seattle, Washington, USA
| |
Collapse
|