The Efficacy of Gabapentin in Patients with Failed Back Surgery: A Prospective Case Series

Objective: Failed back surgery syndrome [FBSS] causes persistent low back problems in approximately 15 percent of patients who undergo spinal surgery for lumbar disc herniation. As reported by recent clinical data, gabapentin, an antiepileptic agent, is increasingly being used for chronic pain, with a favorable side effect profile. The aim of this study was to investigate the efficacy of gabapentin in patients with FBSS associated chronic back pain Methods: Nine patients with chronic back pain diagnosed with FBSS according to clinical, lumbar spinal magnetic resonance imaging and electrodiagnostic findings were studied. Each patient received titrated dosage of gabapentin from 900 to 2400 mg/day. Pretreatment levels of pain and the degree of disability were measured using a visual analog scale and the Oswestry disability index. All nine patients were re-evaluated at six weeks and six months Results: Eight of nine patients reported significant decrease in pain and disability scores at six weeks and six months after treatment. One patient who underwent spinal surgery five times did not report benefit from gabapentin. Gabapentin was well tolerated and there were no significant side effects Conclusion: Our results indicate that gabapentin monotherapy may be an effective adjunct for the treatment of FBSS associated chronic low back pain.