Failed Back Surgery Syndrome

Failed Back Surgery Syndrome

 

Failed Back Surgery Syndrome (FBSS) is a condition in which the issue related to your spine or neck doesn’t resolve after Spine Surgery and the symptoms return after a certain period or immediately. FBSS also named post-laminectomy syndrome can be very disheartening for the patient who was hoping to be relieved of pain post-surgery. 

However, the name of this syndrome is a little misleading and FBS doesn’t mean your back surgery failed. It only means you have pain post-surgery and the result that you and your surgeon were hoping for, which is getting rid of pain, didn’t come about. There are many factors that are out of your control that can lead to FBSS.

It has become a very commonly occurring phenomenon and the success rate decreases with an increase in the number of surgeries of a patient. This is a major reason why non-surgical procedures are preferred over surgery since the outcome is not always a complete recovery.

 

Symptoms of FBSS:

  • Chronic pain in the back and neck.
  • Radiating pain from neck to arms.
  • Numbness, weakness, and tingling sensations in the body.
  • Pain in the legs.
  • Reduced mobility and headaches due to neural issues.

 

Reasons associated with FBSS:

One of the major risk factors associated with this condition is age and multiple surgeries. The presence of another chronic condition, smoking, undiagnosed psychological factors is some other conditions that impact the outcome of surgeries. In 5-10% of patients, recurrent lumbar disc herniation and is most likely to occur within the first three months after surgery. Many of the time, years after spine surgery, lumbar stenosis can come back at the same level or other level resulting in leg pains.

Epidural fibrosis is a rare condition in which post-surgery fibrous scarring around nerve roots can lead to back pain.

Failed back surgery syndrome is a result that either the patient has another secondary problem that needs to be ruled out, or that the lesion operated on was not in fact the source of the patient’s persistent pain

 

Diagnosis of FBS

Diagnosis of this condition is done based on the recent spine surgery and your physician will look for signs that show a connection between your symptoms and the surgery. The pain can also be due to other spinal conditions such as osteoarthritis and natural degeneration of the spine with aging. Your doctor will attempt to rule out the other causes to correctly diagnose you with Failed Back Surgery Syndrome. 

 

Treatment of FBS

If surgery did not provide you with the desirable results and the pain and discomfort persist, you can opt for a multidisciplinary approach that involves multiple therapies and treatments to tackle the various facets of this condition. Your doctor will provide you with a personalized course of action which will include mild to moderate exercises. These will help in restoring mobility and reducing pain. 

 

It is common for patients suffering from long-term chronic pain to face spinal instability and weakness. Your physical therapist will teach you core strengthening exercises which will help in restoring the lost strength and will also help in managing pain. In case of secondary causes of pain such as Lumbar stenosis, degenerative changes in the spine, or post-surgery adhesions your doctor might suggest you Spinal Injection procedure and epidural adhesiolysis.