What defines failed back surgery?
Every year, over 600,000 Americans have back surgery done on them. Out of this population, severalcontinue to feel pain. Failed back surgery is the result of a botch back operation that results in chronic pain for a patient.
Failed back surgery syndrome, as it is known, or FBSS, is when the patient shows signs of severe back pain well after the surgery is over. There are several factors that may contribute to this condition that may have nothing to do with the surgery or the way the person heals after the surgery. These factors may even be due to conditions the patient has faced before the surgery.
What are the causes or reasons for failed back surgery?
Back surgery is mainly performed for the following reasons:
- The stabilization in case of a very painful joint.
- Possible decompression of may be pinched form of nerve root.
- Even cases of normal type of spinal curvature.
- Pain relief.
Therefore, spinal surgery may not always be able to cure the person’s pain and eliminate it completely once the surgery is over. A lot of people who have their spine operated upon have pain that continues to be experienced at 50 percent or even more after the surgery. Another effect may be that the pain continues to be experienced and therefore the person is unable to perform their normal activities such as their daily job.
One main reason for a botch spine surgery could be that while the surgery helped to correct then wound or even herniated disc, it did not cure the body of the pain it experienced (North et al., Johns Hopkins University School of Medicine, 1995). This could be because the wound was not directly responsible for the pain, but the pain may have actually been caused through the curvature of the spine or even other reasons.
In case the back surgery has been completed successfully, even if it has been carried out for the incorrect underlying condition, it would not give the person any elimination of their pain symptoms. Therefore, the reason for the pain continues to exist in the person and pain management procedures need to be conducted.
If particular surgery was not successful, another reason could be that the spine didn’t fuse properly. Therefore, another surgery would be required to repair the damage instead of relying on nonoperative pain management techniques.
Are there back surgeries that will alleviate pain?
Even though failed case of back surgery syndrome cannot always be foreseen, there may be other kinds of a back pain in which there is more effective pain relief as compared to others. For instance:
- Discectomy: In this method, a lower back type of herniation (lumbar) is corrected so that pain is eliminated. Pain in the leg can be cured as a result of the operation. If there was lower back problem even before the surgery, it is likely to continue even after surgery. Therefore, this method may not always work in eliminating lower back pain as compared to the leg pain. An individual may therefore be free of their sciatica but they will always suffer from back pain. Therefore, only part of the issue was resolved by the surgery.
- Spinal fusion: In spinal fusion, in case there is already DDD typically in a lower back area, there may not be effective pain relief post surgery. The pain could therefore become chronic or reduce by around 30 percent to 50%.
What are the potential causes of failed back surgery other than those listed?
Besides the procedures mentioned above, there could be other instances of failed kind of back surgery which could cause a lot of pain after the surgery, such as:
- Scar tissue formation: This is when there is a buildup of the scar tissue surrounding the nerve root. This condition is called Post Laminectomy Syndrome.
- Even Adjacent Segment Degeneration: After surgery, there is more stress applied to the operated region and this could therefore result in pain.
Is there treatment available for failed back surgery syndrome?
Failed back operation can be corrected through several methods. The main method of treatment is to understand how the pain is being caused.
- In case there was a fusion or implantation that was done during the surgery, scans can be taken of the area to determine if this is why the pain is being caused. The specialist can study these X rays as well as CT scan to see check if the required fusion has occurred properly and whether the levels are now stable.
- If a patient still complains about leg pain, the doctor may try to detect if this is due to scar tissue. This can be done using a nerve related conduction study.
- Medicines can be used to help reduce pain that the patient suffers, such as narcotic as well as non-narcotic reducers of pain along with some neurogenic medications – may be Lyrica or even Neurontin.
- Physiotherapy as well as chiropractic treatment together with acupuncture as well as TENS Unit can also be used together with conservative methods of treatment.
- Trigger point type of injections, steroid injections and nerve blocks can also be used for pain reduction.
- In case there is no need for another surgery, another way of treating the failed type of back surgery syndrome can be through stimulation of the spinal cord. This method is used when there is a lot of pain that the individual is experiencing and if no other method of treatment works for the patient any more. Spinal cord’s special stimulator treatment has had a lot of success and more than 80% of complaining patients have seen improvement using this method.
What is the prognosis and outcome for treatment?
While not all methods may be useful, the patient should take a realistic look at the treatment options that are available. No one method shows a 100% rate of recovery. The pain can be said to be cured if it has reduced by 75%.
Your pain doctor can help relieve you of the pain so that you can get back to normal life!