Impact of Failed Back Surgery Syndrome on Health-Related Quality of Life

Purpose: Failed back surgery syndrome (FBSS) is a complex condition often described as persistent, residual, and neuropathic back pain of unknown origin following surgical intervention. The FBSS has proven to be troublesome for patients who experience symptoms and for clinicians tasked with providing effective treatment. As treatment options are still being explored, the progression of FBSS remains uncertain. The aim of this study was to determine the impact of FBSS on health-related quality of life. Methods: The PRECISION Pain Research Registry collects data from participants with chronic low back pain. Registry data were accessed for the Patient-Reported Outcomes Measurement Information System with 29 items (PROMIS-29) to compare a FBSS group with a control group without FBSS over 6 months. Results: A total of 30 participants had surgery following enrollment in the registry, including 14 in the FBSS group and 16 in the control group. The FBSS group reported worse outcomes than the control group at various intervals in the domains of depression (3 month mean: 61.0 vs 53.5, p=.04), sleep disturbance (3 month mean: 60.5 vs 54.9, p=0.04; 6 month: 61.5 vs 55.9, p=0.04), participation in social roles and activities (6 month mean: 37.4 vs 44.4, p=0.04), and pain interference with activities (3 month mean: 68.7 vs 61.5, p=0.01; 6 month: 68.5 vs 61.3, p=0.003). Conclusion: These findings provide insight on the longitudinal impact of FBSS on health-related quality of life, particularly depression, sleep disturbance, participation in social roles and activities, and pain interference with activities.