Failed Back Surgery Syndrome
A general term to describe post back surgery pain, failed back surgery syndrome occurs in patients who have continued pain after surgery.
What is Failed Back Surgery Syndrome?
- For some who have had neck or back surgery, whichever the surgery may have been, chronic pain is still part of their daily lives. Even after fully healing (at least 1 year), symptoms associated with their spinal condition such as pain, weakness, numbness, and others, may still persist.
- Failed back surgery syndrome is not a spinal condition or a symptom, but a general for the persistent pain and related ailments that patients may experience after neck or back surgery.
- Almost 40 percent of patients who have had neck or back surgery still experience pain. The largest reason is because spine surgery was unable to completely decompress the affected nerve(s), and/or stabilize the vertebrae.
- Patients with failed back surgery syndrome usually feel depressed, may become obese due to lack of activity, and feel their quality of life is low. Treatment such as spinal cord stimulation may be recommended.
What causes it?
Experiencing chronic pain after neck or back surgery may be a daunting and extremely disappointing experience for patients. However, nearly 40 percent of patients who have undergone neck or back surgery, for whatever spinal condition, are unsuccessful in gaining a pain-free life.
The reasons for unsuccessful neck or back surgery vary. First, the patient's previous spinal surgeon may have misdiagnosed the patient and recommended the wrong surgery. Sometimes the surgery was performed on an area of the spine that was not affected, and the affected area was left untouched.
Even if the correct surgery was performed in the right area, the fusion and/or hardware used to stabilize the vertebrae may fail. The hardware used to steady the fusion may break after wear and tear or the fusion may not properly set. This may happen especially in patients who are obese or have had more than one set of vertebrae fused.
Pain may also persist if some fragments of disc or bone spurs were missed and remain, continuing to pinch the nerve. Or, the patient may have had permanent nerve damage, which may not be corrected with spinal fusion. Lastly, scar tissue formed around the surgical site may create nerve compression and spinal stenosis, or a narrowing of the spinal canal.
How do you treat it?
There aren't many treatments that may significantly decrease the patient's pain. Some treatments, like steroid injections or medications may temporarily help decrease pain and other symptoms; however, these are only short fixes.
Symptoms such as weakness in the extremities, numbness, and trouble walking or standing straight may persist after additional physical therapy and medications. Sometimes patients develop depression, gain weight, and undergo psychiatric therapy for their pain and low quality of life. These symptoms need to be treated on their own and are not part of their spinal condition's treatment.
Spinal cord stimulation is a surgical procedure that may significantly decrease the patient's pain, but is only recommended once all other forms of treatment are tried. It is a two-part procedure that sends electrical stimulation to the affected nerve. The first part temporarily inserts the electrodes so that the patient may determine if the system will help with pain. If it does, then the system's lead and generator are implanted.
We offer spinal cord stimulation surgery performed by our world-class neurosurgeons in our spine center located in gorgeous Cayman Islands. If you would like to see if you qualify, please send us your MRI scan here and we will review it for free.