Professional Status of Persistent Spinal Pain Syndrome Patients after Spinal Surgery (PSPS-T2): What Really Matters? A Prospective Study Introducing the Concept of “Adapted Professional Activity” Inferred from Clinical, Psychological and Social Influence

Persistent Spinal Pain Syndrome Type 2 (PSPS-T2) represents a main cause of work disruption. Beyond its societal consequences, occupational inactivity is responsible for a major decrease in physical/mental health in individuals but remains poorly analyzed. We designed a study to prospectively examine Professional Status (PS) evolution and its association with key bio-psychological markers. Data from 151 consecutively included working-age PSPS-T2 patients were analyzed to determine the proportion of professional inactivity and the relationships between PS and Social Gradient of Health (SGH), Numeric Pain Rating Scale (NPRS), EuroQol 5-Dimensional 5-Level (EQ-5D-5L), Oswestry Disability Index (ODI), Hospital Anxiety and Depression Scale (HADS), and Fear-Avoidance Belief Questionnaire work subscale (FABQ-W). Despite optimized medical management, 73.5% of PSPS-T2 patients remained inactive after 1 year of follow-up/p = 0.18. Inactive patients presented a low SGH/p = 0.002, higher NPRS/p = 0.048, lower EQ-5D-5L/p < 0.001, higher ODI/p = 0.018, higher HADS-D/p = 0.019 and higher FABQ-W/p < 0.001. No significant mediation effect of FABQ-W on SGH consequences regarding PS was observed in our structural model/p = 0.057. The link between unemployment and bio-psycho-social pain dimensions appears bidirectional and justifies intense collaboration with social workers. Optimizing therapeutical sequencing towards personalized professional plans implies restoring “Adapted Physical Function” as an initial goal, and tailoring an “Adapted Professional Activity”, matching with patient expectations and capabilities, as a final objective.

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Persistent Spinal Pain Syndrome: a proposal for Failed Back Surgery Syndrome and ICD-11

Pain Medicine ◽

10.1093/pm/pnab015 ◽

2021 ◽

Author(s):

Nick Christelis ◽

Brian Simpson ◽

Marc Russo ◽

Michael Stanton-Hicks ◽

Giancarlo Barolat ◽

...

Keyword(s):

Chronic Pain ◽

Spine Surgery ◽

Pain Syndrome ◽

Spinal Pain ◽

Failed Back Surgery Syndrome ◽

Medical Professionals ◽

Failed Back Surgery ◽

Back Surgery ◽

Spinal Pain Syndrome

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 labelled with FBSS. Through a shift in perspective it could facilitate the application of the new ICD-11 classification and allow clearer discussion amongst medical professionals, industry, funding organisations, academia, and the legal profession.

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50 challenging spinal pain syndrome cases

Manual Therapy ◽

10.1016/s1356-689x(03)00042-0 ◽

2003 ◽

Vol 8 (4) ◽

pp. 261

Author(s):

Sara Luetchford

Keyword(s):

Pain Syndrome ◽

Spinal Pain ◽

Spinal Pain Syndrome

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Effect of L-arginine in central spinal pain syndrome

Bulletin of Experimental Biology and Medicine ◽

10.1007/bf02433097 ◽

1999 ◽

Vol 127 (2) ◽

pp. 144-147

Author(s):

E. I. Danilova ◽

V. N. Grafova ◽

M. L. Kukushkin ◽

V. A. Zinkevich

Keyword(s):

Pain Syndrome ◽

Spinal Pain ◽

Central Spinal Pain Syndrome ◽

Spinal Pain Syndrome

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OSOBENNOSTI KLINIKI, DIAGNOSTIKI I LEChENIYa ZABOLEVANIY GRUDNOGO I POYaSNIChNOGO OTDELOV POZVONOChNIKA U BEREMENNYKh ZhENShchIN

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto200310131-35 ◽

2003 ◽

Vol 10 (1) ◽

pp. 31-35

Author(s):

E G Skryabin

Keyword(s):

Clinical Manifestations ◽

Pain Syndrome ◽

Spinal Pain ◽

Negative Influence ◽

Spinal Diseases ◽

Spine Deformity ◽

Posterior Surface ◽

Complex Treatment ◽

Moiré Topography ◽

Spinal Pain Syndrome

Examination of 325 pregnants with spinal pain at different terms of gestation was performed. The nature, rate and main clinical manifestations of vertebral pathology are detected. Taking into account impossibility of radiologic examination the shady moire topography of posterior surface of trunk , which exerted no negative influence on fetus, was used for the diagnosis of spine deformity. Complex treatment with nondrug therapy allowed to eliminate or significantly decrease the spinal pain syndrome. Specially elaborated devices for the diagnosis and treatment of spinal diseases in pregnants were used.

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The Added Value of Subcutaneous Peripheral Nerve Field Stimulation Combined with SCS, as Salvage Therapy, for Refractory Low Back Pain Component in Persistent Spinal Pain Syndrome Implanted Patients: A Randomized Controlled Study (CUMPNS Study) Based on 3D-Mapping Composite Pain Assessment

10.20944/preprints202109.0031.v1 ◽

2021 ◽

Author(s):

Philippe Rigoard ◽

Amine Ounajim ◽

Lisa Goudman ◽

Benedicte Bouche ◽

Manuel Roulaud ◽

...

Keyword(s):

Back Pain ◽

Peripheral Nerve ◽

Salvage Therapy ◽

Pain Syndrome ◽

Spinal Pain ◽

Added Value ◽

Controlled Study ◽

Field Stimulation ◽

Peripheral Nerve Field Stimulation ◽

Spinal Pain Syndrome

While Spinal Cord Stimulation (SCS) provides satisfaction to almost 2/3 of Persistent Spinal Pain Syndrome-Type 2 (PSPS-T2) patients implanted for refractory chronic back and/or leg pain when not adequately addressed the back pain component, leaves patients in a therapeutic cul-de-sac. Peripheral Nerve field Stimulation (PNfS) has shown interesting results addressing back pain in the same population. Far from placing these two techniques in opposition, we suggest that these approaches could be combined to better treat PSPS-T2 patients. We designed a RCT (CUMPNS), with a 12-month follow-up, to assess the potential added value of PNfS, as a salvage therapy, in PSPS-T2 patients experiencing a “Failed SCS Syndrome” in the back pain component. Fourteen patients were included in this study and randomized into 2 groups (“SCS + PNfS” group/n=6 vs “SCS only” group/n=8). The primary objective of the study was to compare the percentage of back pain surface decrease after 3 months, using a computerized interface to obtain quantitative pain mappings, combined with multi-dimensional SCS outcomes. Back pain surface decreased significantly greater for the ”SCS+PNfS” group (80.2% ± 21.3%) compared to the “SCS only” group (13.2% ± 94.8%) (p=0.012), highlighting the clinical interest of SCS+PNfS, in cases where SCS fails to address back pain.

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