Incidence and Prevalence of Persistent Spinal Pain Syndrome type 2: a systematic review with meta-analysis

Abstract

Background and objective: Many definitions have been proposed to describe new, unrelieved, or worsened chronic pain following spine surgery, including Post-Laminectomy Syndrome, Failed Back Surgery Syndrome and Chronic Pain After Spinal Surgery, with overall rates estimated to be between 10 and 40%. Following the need for better definition of these diagnosis the term Persistent Spinal Pain Syndrome type 2 (PSPS2) has been proposed as an all-encompassing classification. The aim of this systematic review was to provide a more accurate estimate of the incidence and prevalence of PSPS2. Databases and data treatment: The systematic review was registered with PROSPERO (CRD42022378867) and performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The review comprised 3 phases: a methodological assessment of 2 different databases identifying potential articles and screening for inclusion criteria by 2 independent reviewers; data extraction; and study quality assessment. Meta-analysis was used to estimate the pooled incidence and prevalence rates using a random effects model. Results: A total of 22 studies were included in the final review with 16 being used in meta-analysis (13 reporting incidence and 3 reporting prevalence). Our analysis found the global estimate of incidence to be 14.0%, (retrospective studies 8.9% and prospective studies 29.7%). The global estimate of prevalence was 42.7%. Heterogeneity in the analysis was overall large, except for prevalence which was moderate. Conclusions: This is the first systematic review and meta-analysis to provide estimates regarding incidence and prevalence of PSPS2, which emphasizes its relevance.