ABSTRACT
Failed back surgery syndrome [FBSS] is a condition where there is a failure to improve satisfactorily following back surgery for herniated discs, stenosis and instability. The syndrome is difficult to treat due to the variability of pain generators. Eighteen patients were evaluated in a prospective study. All had post-operative enhanced magnetic resonance imaging which showed no surgically treatable lesions and no infection but all had variable degrees of epidural fibrosis [EDF]. Vigorous pelvic traction [VPT] was applied twice a week for 4 weeks and patients followed up 3 months post-traction. The mechanical and physiological effects of VPT on the tethering fibrous bands and surroundin 9 structures is the concept of this study. The aim of therapy was focused on the reduction of pain and the enhancement of function. The results showed a definite improvement in many clinical parameters in 16 [88.88%] patients. In conclusion, patients with surgically repairable problems cannot benefit from anything but surgery. However, there is a group for whom surgery is not an option and another group in those where surgery is an alternative but not necessarily one that must be pursued. In both groups, a comprehensive programme of spinal rehabilitation including VPT may be beneficial