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Objective For many medical professionals dealing with patients with persistent pain following spine surgery, the term Failed back surgery syndrome (FBSS) as a diagnostic label is inadequate, misleading, and potentially troublesome. It misrepresents causation. Alternative terms have been suggested, but none has replaced FBSS. The International Association for the Study of Pain (IASP) published a revised classification of chronic pain, as part of the new International Classification of Diseases (ICD-11), which has been accepted by the World Health Organization (WHO). This includes the term Chronic pain after spinal surgery (CPSS), which is suggested as a replacement for FBSS. Methods This article provides arguments and rationale for a replacement definition. In order to propose a broadly applicable yet more precise and clinically informative term, an international group of experts was established. Results 14 candidate replacement terms were considered and ranked. The application of agreed criteria reduced this to a shortlist of four. A preferred option—Persistent spinal pain syndrome—was selected by a structured workshop and Delphi process. We provide rationale for using Persistent spinal pain syndrome and a schema for its incorporation into ICD-11. We propose the adoption of this term would strengthen the new ICD-11 classification. Conclusions This project is important to those in the fields of pain management, spine surgery, and neuromodulation, as well as patients labeled with FBSS. Through a shift in perspective, it could facilitate the application of the new ICD-11 classification and allow clearer discussion among medical professionals, industry, funding organizations, academia, and the legal profession.

INTRODUCTION: This article reports the content validation of a Critical Appraisal Tool designed to Review the quality of Analgesia Studies (CATRAS) involving subjects incapable of self-reporting pain and provide guidance as to the strengths and weakness of findings. The CATRAS quality items encompass 3 domains: level of evidence, methodological soundness, and grading of the pain assessment tool. OBJECTIVES: To validate a critical appraisal tool for reviewing analgesia studies involving subjects incapable of self-reporting pain. METHODS: Content validation was achieved using Delphi methodology through panel consensus. A panel of 6 experts reviewed the CATRAS in 3 rounds and quantitatively rated the relevance of the instrument and each of its quality items to their respective domains. RESULTS: Content validation was achieved for each item of the CATRAS and the tool as a whole. Item-level content validity index and kappa coefficient were at least greater than 0.83 and 0.81, respectively, for all items except for one item in domain 2 that was later removed. Scale-level content validity index was 97% (excellent content validity). CONCLUSIONS: This 67-item critical appraisal tool may enable critical and quantitative assessment of the quality of individual analgesia trials involving subjects incapable of self-reporting pain for use in systematic reviews and meta-analysis studies.

This is the fourth edition of Acute Pain Management: Scientific Evidence. The first three were published in 1999, 2005 and 2010, respectively. This fourth edition sums up the evidence currently available to assist health professionals in the management of acute pain. Additional literature has been reviewed from August 2009 to August 2014. Levels of evidence have been documented according to the National Health and Medical Research Council (NHMRC) designation (NHMRC 1999). The Jadad scoring instrument was used to score the quality of all randomised controlled trials (RCTs) (Jadad 1996). Acute Pain Management: Scientific Evidence messages for each topic are specified with the highest level of evidence available to support them, or with a symbol showing that they are based on clinical experience or expert opinion.

This is the fourth edition of Acute Pain Management: Scientific Evidence. The first three were published in 1999, 2005 and 2010, respectively. This fourth edition sums up the evidence currently available to assist health professionals in the management of acute pain. Additional literature has been reviewed from August 2009 to August 2014. Levels of evidence have been documented according to the National Health and Medical Research Council (NHMRC) designation (NHMRC 1999). The Jadad scoring instrument was used to score the quality of all randomised controlled trials (RCTs) (Jadad 1996). Acute Pain Management: Scientific Evidence messages for each topic are specified with the highest level of evidence available to support them, or with a symbol showing that they are based on clinical experience or expert opinion.

Identifying operations and individuals with an increased risk of chronic postsurgical pain (CPSP) has led to significant interest in interventions with the potential to achieve primary prevention of this condition. Pharmacological prevention remains controversial with a Cochrane review identifying perioperative ketamine administration as the only intervention with possible benefit although, with only small, heterogeneous studies, the authors called for a large randomised controlled trial (RCT) to confirm the validity of this result. In response to these data, a group of researchers from Australia and Hong Kong designed the ROCKet trial - Reduction Of Chronic Post-surgical Pain with Ketamine, endorsed by the Australian and New Zealand College of Anaesthetists (ANZCA) Clinical Trials Network (CTN).

Identifying operations and individuals with an increased risk of chronic postsurgical pain (CPSP) has led to significant interest in interventions with the potential to achieve primary prevention of this condition. Pharmacological prevention remains controversial with a Cochrane review identifying perioperative ketamine administration as the only intervention with possible benefit although, with only small, heterogeneous studies, the authors called for a large randomised controlled trial (RCT) to confirm the validity of this result. In response to these data, a group of researchers from Australia and Hong Kong designed the ROCKet trial - Reduction Of Chronic Post-surgical Pain with Ketamine, endorsed by the Australian and New Zealand College of Anaesthetists (ANZCA) Clinical Trials Network (CTN).

This is the third edition of Acute Pain Management: Scientific Evidence. The first two were published in 1999 and 2005, respectively. This third edition sums up the evidence currently available to assist health professionals in the management of acute pain. Levels of evidence have been documented according to the National Health and Medical Research Council (NHMRC) designation (NHMRC 1999). The Jadad scoring instrument was used to score the quality of all randomised controlled trials (RCTs) (Jadad 1996). Acute Pain Management: Scientific Evidence messages for each topic are specified with the highest level of evidence available to support them, or with a symbol showing that they are based on clinical experience or expert opinion.

This is the third edition of Acute Pain Management: Scientific Evidence. The first two were published in 1999 and 2005, respectively. This third edition sums up the evidence currently available to assist health professionals in the management of acute pain. Levels of evidence have been documented according to the National Health and Medical Research Council (NHMRC) designation (NHMRC 1999). The Jadad scoring instrument was used to score the quality of all randomised controlled trials (RCTs) (Jadad 1996). Acute Pain Management: Scientific Evidence messages for each topic are specified with the highest level of evidence available to support them, or with a symbol showing that they are based on clinical experience or expert opinion.

This is the fourth edition of Acute Pain Management: Scientific Evidence. The first three were published in 1999, 2005 and 2010, respectively. This fourth edition sums up the evidence currently available to assist health professionals in the management of acute pain. Additional literature has been reviewed from August 2009 to August 2014. Levels of evidence have been documented according to the National Health and Medical Research Council (NHMRC) designation (NHMRC 1999). The Jadad scoring instrument was used to score the quality of all randomised controlled trials (RCTs) (Jadad 1996). Acute Pain Management: Scientific Evidence messages for each topic are specified with the highest level of evidence available to support them, or with a symbol showing that they are based on clinical experience or expert opinion.

This is the third edition of Acute Pain Management: Scientific Evidence. The first two were published in 1999 and 2005, respectively. This third edition sums up the evidence currently available to assist health professionals in the management of acute pain. Levels of evidence have been documented according to the National Health and Medical Research Council (NHMRC) designation (NHMRC 1999). The Jadad scoring instrument was used to score the quality of all randomised controlled trials (RCTs) (Jadad 1996). Acute Pain Management: Scientific Evidence messages for each topic are specified with the highest level of evidence available to support them, or with a symbol showing that they are based on clinical experience or expert opinion.