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Most patients who undergo spine surgery find relief from reduced back or neck pain. However, some patients do not get better, and a few patients actually find that their condition has worsened. Failed back surgery syndrome (also called FBSS, failed back syndrome, or post-laminectomy syndrome) is a generalized term that is used to describe the condition of patients who have not had a successful result with back surgery or spine surgery and have experienced continued pain after surgery.
Factors attributed to the onset or development of failed back surgery include:
- Inaccurate diagnosis
- Scar tissue (fibrosis)
- Residual or recurrent disc herniation
- Inadequate (disc) decompression
- Instability of a painful joint above or below the surgery- adjacent level disease
- Pseudoarthrosis – failure of the fusion to take
- Spinal stenosis
- Nerve injury during surgery
- Non compliance post operatively – smoking, narcotic overuse, non compliant activities
- Other
Signs and Symptoms of Failed Back Surgery
Depending on the cause, failed back surgery symptoms can range from mild to severe. Common symptoms associated with FBSS include diffuse, dull, and aching pain involving the back and/or legs after spinal surgery. Other signs and symptoms include abnormal sensory experiences that manifest in sharp, pricking, and stabbing pain in the extremities.
Failed Back Syndrome Diagnosis
The objective of back surgery is to reduce pain by changing the spine’s anatomy. Before a spinal surgery is performed, the doctor must identify the anatomical lesion (injury) that is the probable cause of the back or neck pain. The primary reason back surgeries are not effective and some patients experience continued pain after surgery is because the lesion that was operated on may not, in fact, be the cause of the patient’s pain. In order to find the exact cause of pain, we use advanced testing methods, the highest quality X-rays, MRIs, and CT scans, as well as very specialized diagnostic injections. Despite all diagnostic tests and narrowing the diagnosis as much as possible, patients looking into surgery for pure back pain need to know that there is a percentage of patients that will not improve from surgery despite all appropriate workup, treatment and post operative course.
Treatment for Failed Back Surgery Syndrome
To provide proper treatment, it is imperative to select the right procedure for the right patient at the right time. Once an accurate diagnosis is obtained, we offer the best treatment for the specific problem and for a specific patient. Some patients need further surgery to correct a surgical issue, while others may find symptomatic relief with medications or spinal cord stimulators, and some need a combination of treatments which may include a pain management physician. At University Spine Associates, patients have ample time with the doctor so that their spinal condition is appropriately diagnosed and the best possible tailored treatment is recommended, surgical or non surgical. |
