1. The group of @entity1 with so-called ' @entity11252 ' ( @entity11252 ) is very diverse. Published studies evaluating the outcome of surgical treatment vary widely in terms of surgical interventions that were performed. Results from these papers cannot be generally applied to all @entity1 who have persisting complaints after low back surgery. 2. The literature search that was performed demonstrated that the articles that scored as acceptable on assessment bias demonstrated a low to moderate @entity1 -perceived recovery percentage. The only randomized controlled trial on this topic did not demonstrate a difference between instrumented fusion and cognitive intervention and exercise. 3. Current research does not show repeat surgery to be successful in ' @entity11252 @entity1 ', but clinical practice indicates that, in a small, carefully selected group, repeat surgery can yield rewarding results. However, parameters that make a @entity1 prone to recover from a subsequent surgical intervention cannot be found in the literature. 4. The term ' @entity11252 ' implies a causative role of surgery in a problem situation; @entity11252 is frequently regarded as failed back surgery. The literature does not, however, provide evidence for this. 5. It is important to inform the @entity1 adequately to shape realistic expectations. Preoperative evaluation of parameters evaluating the @entity558 could help to better predict the outcome of surgery. 6. The term ' @entity11252 ' has been demonstrated to be an ill-defined term, serving as a container for all kinds of back and leg problems, and wrongly implying a definite role for the surgical intervention in the aetiology. We suggest shifting the paradigm to ' @entity11252 '. With this term we suggest defining those @entity1 with back and radicular leg @entity158 without a structural deficit, or with a structural deficit that has a low a priori chance of benefiting from a surgical intervention.

XXXX : time for a paradigm shift.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'people'] @entity11252 :: ('MESH:D055111', 'Disease') :: ['failed back surgery syndrome', 'FBSS', 'failed back syndrome'] @entity558 :: ('MESH:C536528', 'Disease') :: ['psychological condition'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain']
@entity11252 :: (MESH:D055111,Disease) :: ['Failed back (surgery) syndrome']
