What is Failed Back Surgery Syndrome?

Failed back surgery syndrome (also called FBSS, or failed back syndrome) is a generalized term used to describe ongoing pain after back surgery. After going through a spinal surgical procedure, of course, both you and your surgeon desire your complete painlessness. However, even with the best spinal surgeon and the best indications for spinal surgery success, there is always a small chance that back pain may continue after surgery and recovery (studies report continued back pain after 5% of all spinal surgeries).

What causes Failed Back Surgery Syndrome? 

There are many reasons why a back surgery might not result in a completely pain-free existence, partially owing to the fact that spine surgery is only able to accomplish stabilizing a painful joint and decompressing a pinched nerve. If your back condition involves more than these two pain-causing situations, your spine surgeon will need to continue your care and explore additional solutions to your back pain condition.

It should be understood that back surgery is not guaranteed to reduce a person’s pain levels and is primarily a procedure to improve the condition of your spine and prevent any further damage in the future.

How successful is back surgery?

Back surgery is reported to be 95% successful at changing anatomy that causes pain and correcting the physical results of a back injury.  But it’s also important to realize that back surgery isn’t a cure-all for every type of back pain-causing condition. Since the spine is a very complex part of your anatomy, with many vertebrae, nerves, and cushioning between your discs, it can be a complex process to get to the root of what’s truly causing you pain.

How do you know if you require back surgery?

Your back surgeon will thoroughly assess your back pain condition and use top technology to diagnose your back pain causes, but it’s important for you to have realistic expectations of what back surgery can and cannot accomplish for you. If you experience Failed Back Surgery Syndrome, your skilled physician will then conduct additional tests and map out a plan of action to remedy as much of your back pain as possible. All valuable things take time, so don’t set yourself up for possible disappointment by expecting a quick fix to any back pain. It may take an extra procedure or extra treatment after your back surgery to get you feeling much better.

If you do have great success after your back surgery, then you’re in that fortunate 95% of back pain patients whose symptoms lessen and whose lifestyle will very soon be active and more comfortable again.

Procedures that could lead to Failed Back Surgery Syndrome

Discectomy/ Microdiscectomy – To remove a herniated lumbar disc that causes back or leg pain. This operation has a high success rate when treating leg pain and the outcome is very predictable, however, the chances of success are significantly lower for back pain. 

Spinal Fusion Surgery – Surgery to provide stability to the spine by fusing vertebrae together using a bone graft, in addition to metal pins, rods, and sometimes a plate. This is often the solution for a person suffering from spondylolisthesis. Although improved stability is usually guaranteed, the likelihood of reduced pain levels is much lower.

In some cases, this procedure could result in fusion and/ or implant failure where the body effectively rejects the foreign materials. Spinal fusion surgery could also lead to a transfer lesion, this is when one of the vertebrae next to the problem area is damaged, leading to the degeneration of what was previously a healthy bone.

Lumbar Decompression Surgery – Lumbar decompression surgery also offers no guarantees, with some chance that spinal stenosis or disc herniation could recur. It is also possible that the decompression of the nerve root was not sufficient enough, or that the damaged nerves do not heal correctly following the procedure. The surgery may even cause additional damage to the nerve roots, potentially worsening the pain. 

Scar Tissue – Epidural fibrosis is the result of excessive scar tissue near a nerve root following surgery, most common following spinal surgery. The scar tissue effectively attaches itself to the nerve root and causes significant pain. Unfortunately, epidural fibrosis could even occur following a successful operation and is somewhat of unavoidable risk. 

These issues may require postoperative rehabilitation to fix the secondary pain caused by an unsuccessful procedure. 

What are my options if I have Failed Back Surgery Syndrome?

Fortunately, FBSS can be managed and anyone suffering from the failed back surgery does not need to expect long-term and constant pain. There are many ways in which a person can manage their failed back surgery syndrome so they can ease pain levels and return to a normal way of life. 

Physical Therapy – One of the most effective ways of managing FBSS is by employing the services of a physical therapist who can work closely with you to help strengthen your back muscles, achieve proper posture and help to manage any pain you may be experiencing. 

Lifestyle Adjustments – Ensuring you are doing all you can to limit the impact of FBSS is one of the simplest ways to manage the problem. This can be as simple as sleeping in the correct position (on your back or side, as opposed to your stomach), making sure you wear appropriate footwear on certain occasions, and watching your diet to avoid weight gain.

Regularly seeing a masseuse is also a good way to reduce inflammation. 

Medication – Prescribing medication for FBSS is somewhat of a controversial topic as it can be easy for a person to become overly dependent on painkillers, or possibly even addicted. This is why it is extremely important to carefully manage your medication, ensuring it is only used whenever the pain reaches significant levels. Other forms of treatment such as physical therapy and lifestyle adjustments should be the primary methods used to reduce pain. 

Medication can also result in numerous side effects when taken frequently, including; depression, constipation, damage to the immune system, and deterioration to your overall health. 

Spinal Cord Stimulation Devices – These devices have been gaining in popularity in recent years, especially among FBSS sufferers as they have proven successful in reducing severe pain symptoms. They work by using neurostimulation to stop pain signals from reaching and registering with the brain and are an alternative to medication and traditional treatments.

Focus on your mental health – Do not let your symptoms get you down and focus on maintaining a healthy lifestyle, with plenty of exercises. If you feel like your mental health is deteriorating then please pay a visit to your doctor who can refer you to a specialist.