Dear Colleagues,

Painful conditions and spinal disease are highly prevalent in society, resulting in a significant impact on the individual due to the disability of the condition and direct costs of treatment. Furthermore, society is affected by the indirect costs and a loss of productivity. In one study from Nordic countries, more than half of individuals reported back pain in the past 12 months (Ihlebaek, TH, et al., Scandinavian Journal of Public Health, 2006), and more than 20% of these individuals had a work absence due to back pain. The most common musculoskeletal pains reported are shoulder, low back, and chronic widespread pain (McBeth J, et al., Best Practice & Research Clinical Rheumatology, 2007), and the total cost of musculoskeletal related pain conditions in the USA has been estimated at $215 billion. Direct medical costs accounted for 41% of the total, and the remaining were indirect costs associated with the morbidity or mortality of the condition (Baldwin ML, Journal of Electromyography and Kinesiology, 2004). An additional burden of pain is found in cancer patients, among whom one half or more experience moderate to severe pain (Paice JA, Oncology, 2018). In the United States, 1,735,350 new cancer cases are projected to occur in 2018, whereas the lifetime probability of being diagnosed with invasive cancer in the United States is over 37% (Siegel RL, et al, Cancer statistics, 2018). Data from National Hospital Ambulatory Medical Care Survey identified that headache or pain in the head was the fifth leading cause of visits to the Emergency Department overall and the third leading patient-reported reason for ED visits for women aged 15–64 (Smitherman TA, et al, Headache, 2013).

The burden of painful conditions and spinal disease is enormous. However, the current opioid crisis has demonstrated the serious limitations of medical therapy for the treatment of pain, which means that more urgently then ever our patients need effective and safe surgical options to lessen the disability and reduce the burden of intractable pain. This Special Issue of Brain Sciences will be devoted to investigations and reviews of surgical treatments and approaches that are available today or may soon become available to effectively treat intractable pain and spinal conditions.

Dr. Warren W. Boling
Guest Editor

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• pain
• spine and spinal disease
• surgery
• intractable pain