Management of Chronic Pain in Post-Surgical Spinal Syndromes

Chronic pain following spinal surgery represents a significant clinical challenge, often arising from a combination of structural, neurophysiological and psychosocial factors. Management strategies have evolved from purely pharmacological regimens towards integrated, individualised care pathways that combine minimally invasive interventions, rehabilitative modalities and risk stratification tools. Central to modern practice is a multidisciplinary approach that melds surgical, pain-specialist and rehabilitation expertise to address remodelling of epidural scar tissue, neural sensitisation and functional impairment. Novel molecular therapies targeting fibrotic matrix deposition complement advanced imaging-guided procedures such as adhesiolysis and percutaneous decompression. Simultaneously, predictive algorithms and comprehensive response indices are refining patient selection and outcome evaluation, enabling early identification of high-risk individuals and tailored therapy. Emphasis on telehealth-delivered rehabilitation and culturally adapted integrative medicine further broadens access and aligns management with patient preferences, offering global relevance and practical application.

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Management of Chronic Pain in Post-Surgical Spinal Syndromes publication trend

The graph below shows the total number of articles in management of chronic pain in post-surgical spinal syndromes across all publications each year (not limited to Nature Index journals).

Technical terms

Failed back surgery syndrome (FBSS): Persistent or recurrent spinal pain after one or more operative interventions.

Epidural fibrosis: Formation of scar tissue in the epidural space that can tether nerve roots and contribute to chronic pain.

Teleexercise: Delivery of prescribed exercise interventions via telehealth platforms, enabling remote monitoring and customised rehabilitation.

Multidimensional Clinical Response Index (MCRI): Composite metric integrating pain, function, psychological and quality-of-life domains to evaluate treatment efficacy in chronic spinal pain.

References

1. MicroRNA-29a Mitigates Laminectomy-Induced Spinal Epidural Fibrosis and Gait Dysregulation by Repressing TGF-β1 and IL-6. International Journal of Molecular Sciences (2023).
2. Risk factors analysis and risk prediction model for failed back surgery syndrome: A prospective cohort study. Heliyon (2024).
3. Teleexercise for geriatric patients with failed back surgery syndrome. Frontiers in Public Health (2023).
4. A Novel Multi-Dimensional Clinical Response Index Dedicated to Improving Global Assessment of Pain in Patients with Persistent Spinal Pain Syndrome after Spinal Surgery, Based on a Real-Life Prospective Multicentric Study (PREDIBACK) and Machine Learning Techniques. Journal of Clinical Medicine (2021).