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Treating Failed Back Surgery Syndrome

Published May 8, 2018
  | Medically Reviewed by John Santa Ana, M.D.

Unfortunately for the nearly 600,000 Americans that undergo spine surgery each year, many of them will experience more pain and problems post-surgery. In fact, nearly 40 percent of those patients will suffer from failed back surgery syndrome, or FBSS. This problem is so wide-spread, that spine surgery is the only operation that has a condition named for its low success rates.

What is Failed Back Surgery Syndrome?

Despite the name, failed back surgery syndrome is not so much a syndrome but is a general term that refers to an unsuccessful back surgery that brings along chronic back pain instead of relief. Symptoms to look for three months after surgery include both sharp and dull pain, numbness and unusual burning sensations in the back or legs. If symptoms continue to worsen after three months of the back surgery, it might be time to consider seeking additional treatment options to relieve this chronic pain.

Besides managing back discomfort, part of the challenge for those that experience FBSS is pinpointing what caused the surgery to be unsuccessful. Multiple factors that can contribute to FBSS range anywhere from a misdiagnoses or wrong treatment option, to daily habits like smoking and even autoimmune diseases. Regardless of what caused the patient’s FBSS, conservative treatment and other medical procedures can all be options for treating this condition.

Treatment Options 

There are many physical therapy options for those with failed back surgery syndrome. An accurate back pain diagnosis is the first step in finding the most effective treatment option for each individual. Before considering surgery, most treatment plans include a combination of conservative, or non-surgical options.

In most cases, physical therapy and medications will be the first conservative options for managing failed back surgery pain. Even for those who are experiencing back pain for the first time, physical therapy is considered to be the first treatment option. When these conservative options fail to control the pain brought on by FBSS, minimally invasive injections and other medical procedures are the next alternative options for blocking nerve pain.

Before resorting to a repeat surgery, patients with failed back surgery syndrome have benefitted from interventional procedures like injections and stimulations. Epidural steroid injections are one of the most common treatment options for treating pain and inflammation, however spinal cord stimulations (SCS) are on the rise for treating chronic back pain conditions.

Each year, as many as 34,000 spinal stimulator devices are implanted for patients suffering from chronic back pain, accounting for over 70 percent of all neuromodulation treatments. While a stimulator won’t cure back pain, it should be seen as a treatment that will reduce back pain by 50 to 70 percent. Patients who still experience the chronic back pain of FBSS after trying conservative and interventional treatments may have to undergo corrective surgery in order to be pain-free.

Surgery Options 

When conservative options, injections and spinal cord stimulation fail, surgery is the last option for alleviating the pain brought on from failed back surgery syndrome. These surgeries include discectomy, laminectomy, laminotomy or artificial disc replacement.

Starting with a discectomy, this procedure is commonly used for recurrent herniated discs that may happen after spinal surgery. The ruptured portion of the vertebral disc is removed from the spine, alleviating pressure and pain on the back. Over the years, this procedure has become minimally invasive, leading to a fast recovery for all patients including those suffering from failed back surgery syndrome.

Another surgical procedure option for treating failed back surgery syndrome as well as spinal stenosis is a laminectomy. The surgery decompresses the nerve roots on the spinal cord, while also removing or trimming the vertebrae’s lamina within the affected area. The extra space made from removing the lamina, relieves the compressed nerves as well as reduces inflammation. Much like a laminectomy, a laminotomy creates an opening in the lamina rather than removing that part of the vertebrae. Both procedures are meant to relieve pressure and are commonly used to give surgeons an ample amount of space to remove the compressed material that is causing discomfort.

When conservative options, injections and spinal cord stimulation fail, surgery is the last option for alleviating the pain brought on from failed back surgery syndrome.

When these surgeries are not options for treating failed back surgery syndrome, a final surgical option may be artificial disc replacement. In addition to alleviating back pain, artificial disc replacement, or ADR, can help patients with back flexibility and mobility. Instead of just removing the damaged vertebral disc, an artificial disc is inserted in the patient's spine using a combination of interbodies, plates, rods, and screws to ensure the patient’s new disc can heal as one.

The low success rate that comes with back surgeries has millions of Americans searching for back pain relief everyday. While there is no guarantee that these options will work for every case of failed back surgery syndrome, it is important for patients to explore all possible treatments before resorting to an additional surgery. Connect with a free Back Wellness Coach today to help guide you on your journey to a pain free back.  

Updated: February 13, 2020

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