# Central Nervous System Amplification in Lumbar Failed Back Surgery Syndrome

> **NIH NIH K23** · UNIVERSITY OF KANSAS MEDICAL CENTER · 2020 · $194,824

## Abstract

ABSTRACT
 Spine pain is the most common reason for which patients visit their doctor. Between 12-15% of the U.S.
population seek care each year with associated costs exceeding $200 billion.1-3 Although the majority of pain
patients can be managed with conservative therapy, there are millions of individuals who each year undergo
surgery for an existing and refractory chronic pain condition, including surgeries such as lumbar spine surgery
or joint arthroplasty.4-9 One of the most challenging sequelae for these patients is the failure to derive pain
relief despite the surgical intervention. Lumbar failed back surgery syndrome (FBSS) is one of the most under-
studied post-surgical pain syndromes and embraces a constellation of conditions describing recurrent or
persistent low back pain, with or without leg pain, following one or more lumbar spine surgeries.10
 Research has shown that there may be common characteristics at the individual level that contribute to
poor analgesic outcomes after surgical procedures performed for the relief of pain.11-14 Individuals who fail to
get meaningful relief of pain after surgery have been shown to share commonalities in how their central
nervous systems (CNS) process and modulate nociceptive stimuli - known as CNS pain amplification or
centralized pain - that can predispose them towards developing chronic pain after surgery. To date, there
exists not even a single study investigating for the presence of CNS pain amplification in FBSS patients. Our
overall hypothesis is that although peripheral nociceptive input is important in the initiation and maintenance
of pain and symptom expression, patients who do not have a favorable analgesic outcome after lumbar spine
surgery (FBSS) likely possess evidence of increased CNS pain amplification that contributes to the persistent
expression of pain and co-morbid symptoms. The proposed novel initial studies are foundational and the
necessary first steps to proving the presence of CNS pain amplification in this population, which will be the key
driving force for a new avenue of research into this condition. The short-term goals of this K23 proposal are to
use multiple rigorous research methods to establish that patients who fail to derive pain relief from lumbar
spine surgery (FBSS) exhibit phenotypic and physiologic evidence of CNS amplification and centralized pain.
Based on these findings, an R01 will be submitted to advance our long-term goal of designing and performing
large-scale studies that will move us towards mechanisms-based “personalized analgesia” treatment strategies
and risk stratification for lumbar spine surgery patients.
 The Candidate has shown a strong commitment to an academic career and has already performed
impactful studies in the area of chronic pain. She has carefully selected multidisciplinary didactic and hands-on
experiential training that will complement her existing knowledge and skill set. The proposed mentored career
development award will ena...

## Key facts

- **NIH application ID:** 9915937
- **Project number:** 5K23GM123320-04
- **Recipient organization:** UNIVERSITY OF KANSAS MEDICAL CENTER
- **Principal Investigator:** Andrea Lynn Chadwick
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $194,824
- **Award type:** 5
- **Project period:** 2017-05-01 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9915937

## Citation

> US National Institutes of Health, RePORTER application 9915937, Central Nervous System Amplification in Lumbar Failed Back Surgery Syndrome (5K23GM123320-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9915937. Licensed CC0.

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