Failed Back Surgery Syndrome is a general term used to describe the condition of a patient who experienced unsuccessful spine surgery results. Specifically, it applies when spine surgery has not alleviated the original problem. Or, when it has originated other, and more significant issues. Therefore, resulting in continuing or worsening pain.
Shockingly, it is estimated that up to 40 percent of patients who undergo traditional open back surgery experience failed back surgery syndrome! The incidence of failed back surgery syndrome (FBSS) depends upon many factors. For instance, it tends to occur more frequently in the lumbar region (lower back), than in the cervical area (upper back) of the spine.
Additionally, your risk of developing FBSS is much higher following an open spinal fusion procedure than after undergoing a minimally invasive technique.
Based on the studies published to date by the U.S. National Institutes of Health, the only scientifically defensible statement that can be made about the incidence of failed back surgery syndrome is that its likelihood increases with the invasiveness of the spinal surgery that was performed.
Failed Back Surgery Syndrome Signs
How to recognize if you have failed back surgery syndrome? If you have FBSS, you may experience or develop symptoms in varying degrees of severity, such as:
- Continued or chronic pain
- Several patients experience worsened pain or symptoms than before their procedures
- New spine conditions
- Pain above or below the treated level of the spine
- Limited mobility
- Inability to recuperate
- Dull, aching pain in the neck, back or legs
- Sharp or stabbing pain in the extremities
- Spinal joint immobility
- Dependence on prescription drugs
Treatment for failed back surgery syndrome may be necessary to ease severe pain. Sometimes, also to address muscle weakness, numbness, tingling, spasms, sleep disturbances, or depression. Treatment options can vary. FBSS can result from a variety of causes and create several different symptoms. A failed back surgery syndrome treatment plan will usually begin with one or more nonsurgical therapies. Before any further surgery is considered, the following conservative methods are used:
- Physical therapy
- Hot/cold compresses
However, in a minority of cases, revision surgery is ultimately necessary.
Failed Back Surgery Syndrome Causes
Failure to Correctly Diagnose
Surgeons who see a low volume of patients with degenerative spine conditions tend to be less experienced and specialized in diagnosing and treating these conditions. As a result, when determining the underlying cause of a patient’s neck or back discomfort, a relatively inexperienced surgeon might attempt to correlate a patient’s pain pattern with a specific area of degeneration in the spine. However, the process of making an accurate diagnosis is not always this straightforward.
Other sources of pain, such as hip osteoarthritis, can produce very similar symptoms. Therefore, often incorrectly attributed to degenerative spine conditions. Based on an improper diagnosis, a surgeon might perform surgery at the wrong level of the spine. Or, otherwise, improperly treat, which leads to FBSS.
Failure to adequately decompress a nerve root or otherwise, treat the condition(s). A technical error on the part of a treating surgeon, such as leaving behind a bone fragment or some herniated disc material that is pressing on a nerve root or the spinal cord, can result in pain that continues or worsens after surgery.
Spinal Fusion Failure
The goal of a traditional spinal fusion procedure is to relieve nerve compression by removing a damaged disc and stabilizing the adjacent vertebrae with bone grafts or implants that are naturally fortified as the body heals after surgery. However, to successfully address neck or back pain through spinal fusion, a surgeon must first accurately identify the source of a patient’s pain. Furthermore, every patient heals at a different rate. Because vertebral fusion takes place as part of the healing process, it can take up to several months to achieve a solid fusion in some patients. However, in others, it may never occur.
Implant migration. Sometimes, an implant can shift after being placed by a surgeon. This most often occurs during recovery, before the body’s healing process has progressed to the point that the implant has attached firmly to the vertebrae. An implant that has moved out of its intended spot will be less effective — or completely ineffective — at stabilizing the spine. Moreover, if a displaced implant compresses sensitive neural tissue, it could create a painful new spine condition.
Scar Tissue Formation
As part of the natural healing process, the body forms bands of scar tissue following any form of tissue disturbance, such as spine surgery. These fibrous adhesions can potentially bind a nerve root, resulting in a condition called epidural fibrosis, which can lead to postoperative pain and FBSS.
Decompressing a nerve root through spine surgery will typically cause temporary inflammation, and can lead to increased pain until it subsides. However, in rare cases, nerve damage can occur, resulting in symptoms like chronic pain and weakness in certain muscle groups.