FAILED BACK SURGERY SYNDROME Failed back surgery syndrome (FBSS) describes a situation in which back pain and/or leg pain recur or persist following seemingly successful back surgery. The cause(s) of FBSS are unknown and probably multiple. Scarring in and around the nerves is often seen, and has been blamed for this condition in many cases. In many other cases, no cause can be found for continued or recurrent symptoms. FBSS may be extremely troubling and disabling. Patients with FBSS often undergo multiple evaluations, surgeries, courses of therapy, and visits to pain clinics. Following initial injury to the nerves (as in a disc herniation), local repair and regeneration can sometimes result in abnormal signal transmission which is interpreted as pain. Abnormal regeneration can complicate the management of pain following back surgery, and may explain why repeated surgery for disc herniations sometimes fails to relieve the pain. Pain resulting from abnormal firing of nerves is sometimes called neuropathic pain. Treatment consists of the entire myriad of pain management continuum including physical therapy, pharmacological management, nerve blocks, neurostimulation, and implantation of intrathecal drug delivery systems.