Back pain can be excruciating. It is known to cause more disability than any other condition. For some, the only resort is surgery. Unfortunately surgery may not always work. In fact more often than not surgery fails. That doesn’t mean it shouldn’t be attempted. It just means you need to understand what to expect from surgery. In this article, we at Spinalogy Clinic, Pune explore what exactly Failed Back Surgery Syndrome is.
What is Failed Back Surgery Syndrome (FBSS)?
Failed Back Surgery Syndrome (or FBSS) refers to the persistent pain a patient may experience even after a back surgery. It is also called post-lumbar surgery syndrome, post-laminectomy syndrome or post operative persistent syndrome. The pain from FBSS may be experienced in the back or even in the legs. Sometimes it may worsen over time.
Having this condition does not imply that there was necessarily a problem during the surgery. In fact even with the best surgeons and equipment, there is a possibility of developing FBSS. It also does not mean that there is nothing that can be done to improve a patient’s condition. Revision surgeries are regularly recommended. Overall the term FBSS is a misnomer. The only thing it defines for certain is that the surgery performed did not give the desired results.
Causes of Failed Back Surgery Syndrome:
To understand why a spine/back surgery could fail, we must first understand what this surgery has the potential to achieve. A back surgery aims to stabilize a painful joint and/or decompress a pinched nerve. By definition it makes changes to the body in an attempt to fix the situation. However it does not magically get rid of the pain.
All surgeries come with some amount of risk. The risks in a back surgery can occur at any point through the surgery process i.e. – Before, during and after the surgery.
For example, if you suffer from metabolic problems like diabetes you may not be an ideal candidate to undergo back surgery in the first place. Similarly, if you are prone to psychological problems such as anxiety and depression, you are at a higher risk of developing FBSS. The surgeon too needs to do thorough evaluation of patient before performing the surgery as in certain cases it can be difficult to identify the pain generator.
After the surgery there can be a host of other reasons for FBSS to develop. Infection is one such common reason.
Scar tissue may also form around the spinal nerve root. This is a problem only if the pain develops between 6-12 weeks after surgery. This is how long it takes for scar tissue to form. These scar tissue form epidural adhesions which trap nerves and cause neuropathic pain after spine surgery.
Spine surgeries can alter spine biomechanics and cause strain on facet joints, sacro-iliac joints, which can be the cause of pain after spine surgery.
In certain cases, implants like screws and rods fixed in spine cane become lose or displaced and cause back pain after spine surgery.
Surgeries More Prone to Failed Back Surgery Syndrome:
Believe it or not, which type of surgery you choose to have can determine if you are more prone to developing FBSS.
Discectomy is a procedure in which fragments of a herniated disc are removed. This helps take the pressure of the spinal nerves. There are different kinds of discectomies. A discectomy for a lumbar disc herniation that is causing leg pain is predicted to be more successful than if it were causing lower back pain. Similarly a laminectomy, where a part of the vertebra is removed to make space for the nerves to pass through, Can cause post surgical pain due to instability of spine.
How to Move Forward after a Failed Back Surgery Syndrome?
If you have suffered FBSS, don’t lose heart. Very often revision surgeries are recommended and help correct the problem. Apart from this medication, neuromodulation, holistic therapies and a multidisciplinary approach such as we at the Spinalogy Clinic, Pune follow can greatly help FBSS.
Being aware of FBSS will help you avoid it as well. If you are recommended back surgery, spend some time understanding how prone it is to develop FBSS. At the Spinalogy Clinic, Pune, we prefer to avoid a surgery. Our non-surgical treatment methods and multi-disciplinary approach to back problems may just be the solution you have been looking for.
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