ArticlePain medicine (Malden, Mass.)2021
Persistent Spinal Pain Syndrome: A Proposal for Failed Back Surgery Syndrome and ICD-11.
Article in Pain medicine (Malden, Mass.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06272539 (Spinal Cord Stimulation Combined With Exercise in Patients Diagnosed With Persistent Spinal Pain Syndrome. A Randomized Control Trial), which is not on this map. Cited by 88 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Spinal Cord Stimulation Combined With Exercise in Patients Diagnosed With Persistent Spinal Pain Syndrome. A Randomized Control Trial (RCT)
Who cites it
88 citing papers in PubMed, 3 syntheses or guidelines pooled it, 162 citations in OpenAlex.
- The Implementation of Persistent Spinal Pain Syndrome (PSPS): Mechanism-Based Recommendations.Pain practice : the official journal of World Institute of Pain · 2026Guideline
- Does rehabilitation improve work participation in patients with chronic spinal pain after spinal surgery: a systematic review.Journal of rehabilitation medicine · 2025Pooled it
- Clinician approaches to spinal manipulation for persistent spinal pain after lumbar surgery: systematic review and meta-analysis of individual patient data.Chiropractic & manual therapies · 2023Pooled it
- Objective, long-term mobility data in patients with chronic pain after lumbar spine surgery treated with spinal cord stimulation-a prospective, multicenter trial.Regional anesthesia and pain medicine · 2026Trial
- Early outcomes with a flexible ECAP based closed loop using multiplexed spinal cord stimulation waveforms-single-arm study with in-clinic randomized crossover testing.Pain medicine (Malden, Mass.) · 2025Trial
- Efficacy of Epidural Pulsed Radiofrequency Treatment in Persistent Spinal Pain Syndrome: A Prospective Clinical Study.Pain research & management · 2025Trial
- Postoperative early initiation of sequential exercise program in preventing persistent spinal pain syndrome type-2 after modified transforaminal lumbar interbody fusion: a prospective randomized controlled trial.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Trial
- Treatment of Refractory Low Back Pain Using Passive Recharge Burst in Patients Without Options for Corrective Surgery: Findings and Results From the DISTINCT Study, a Prospective Randomized Multicenter Controlled Trial.Neuromodulation : journal of the International Neuromodulation Society · 2023Trial
- The Effects of Auricular Acupressure on Low Back Pain, Neuropathy and Sleep in Patients with Persistent Spinal Pain Syndrome (PSPS): A Single-Blind, Randomized Placebo-Controlled Trial.International journal of environmental research and public health · 2023Trial
- Comparison of Spinal Cord Stimulation vs. Dorsal Root Ganglion Stimulation vs. Association of Both in Patients with Refractory Chronic Back and/or Lower Limb Neuropathic Pain: An International, Prospective, Randomized, Double-Blinded, Crossover Trial (BOOST-DRG Study).Medicina (Kaunas, Lithuania) · 2021Trial
- Experiences of Rehabilitation Professionals in Guiding Rehabilitation for People with Persistent Spinal Pain Syndrome Type 2: A Qualitative Study.Journal of occupational rehabilitation · 2026Article
- Passive recharge burst spinal cord stimulation for the treatment of refractory nonsurgical low back pain: 24-month results from a prospective randomized controlled trial and predictors of success.North American Spine Society journal · 2026Article
- Peripheral artery disease in patients with persistent claudication after lumbar spine surgery: a primary care reassessment framework.Family medicine and community health · 2026Article
- Predictors of Treatment Success Following Pulsed Radiofrequency of the Lumbar Dorsal Root Ganglion: A Multivariable Prediction Model with Clinical Nomogram.Current pain and headache reports · 2026Review
- Autonomic Dysfunction, Psychosocial Factors, and Pain Sensitivity in Persistent Spinal Pain: A Systematic Review.Journal of clinical medicine · 2026Review
- Long-Term Effectiveness and Safety of Dorsal Root Ganglion Stimulation for Persistent Spinal Pain Syndrome: Results From an Expanded Prospective Registry.Pain practice : the official journal of World Institute of Pain · 2026Article
- Article
- Incidence and preoperative risk factors for failed back surgery syndrome: a nationwide population-based cohort study.Scientific reports · 2026Article
- Failed back surgery syndrome after non-instrumented lumbar surgery: Clinical report of a Tertiary care neurosurgical center.Pakistan journal of medical sciences · 2026Article
- Imaging persistent spinal pain syndrome and spine surgery complications: an interpretation guide for radiologists.Insights into imaging · 2026Article
28 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
25 authors at 20 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveFor 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.
methodsThis 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.
results14 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.
conclusionsThis 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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.