Beneficial response to gabapentin portraying with interval change of brain SPECT imaging in a case with failed back surgery syndrome

What is known and Objective: Failed back surgery syndrome (FBSS) is a well‐recognized consequence of surgery of the lumbar spine. Here, we present a case with FBSS associated neuropathic pain. Case summary: During hospital stay, the patient was stabilized with gabapentin 200 mg twice a day and this was titrated to a dose of 1200 mg per day over the period of 1 week. The treatment produced a substantial reduction in his episodic pain. We assessed regional cerebral blood flow (rCBF) by using brain single photon emission computed tomography (SPECT) scans, which were performed before and after gabapentin treatment 1 week later. The examination of the first SPECT showed decreased uptake in left fronto‐temporal‐parietal region. The latter one showed much improvement of the above areas. What is new and Conclusion: The gabapentin has beneficial effect in the FBSS associated neuropathic pain. Besides, this case suggests the association between rCBF and pain associated with FBSS, as well as the association of gabapentin and altered blood flow of brain cortex.