Acupotomy Combined with Korean Medicine Treatment for a Patient with Failed Back Surgery Syndrome: A Case Report

Failed back surgery syndrome is a condition in which symptoms persist, recur, or develop after spinal surgery. Lumbar herniated intervertebral disc (HIVD) can cause low back pain along with pain and numbness in the lower extremities. However, these symptoms can be a result of referred pain in the soft tissue of the sacroiliac joint (SIJ). Therefore, careful evaluation of pain patterns and thorough physical examination are crucial for differential diagnosis. Acupotomy, utilizing specialized needles that combine the features of a scalpel and an acupuncture needle, is effective in dissecting soft tissue adhesions. This report presents the case of a 48-year-old male with an 8-year history of lumbago and left lower extremity pain and numbness, refractory to two surgical interventions. Careful physical examination, including specific tenderness patterns, led to a diagnosis of SIJ dysfunction rather than recurrent HIVD. His symptoms disappeared after 13 treatment sessions of acupotomy combined with Korean medicine.