The title given to the condition of failed back surgery syndrome is more of generalized term used to describe the re-emergence of symptoms rather than a proper name, as this is not actually a syndrome.
Patients who have had a spine or back surgery not provide the intended amount of relief are said to suffer from failed back surgery syndrome. For many of these patients, there is a continuation of pain symptoms felt even after surgery.
What causes Failed Back Surgery Syndrome?
There are a multitude of reasons that a back or spine surgery may not provide the intended relief for a patient, as no surgery is guaranteed to be a success. Even with the best surgeon and the best outlook for the surgery, studies show that over 40% of back surgeries fail within two years.
Further Causes of Failed Back Surgery Syndrome
In addition to the general reasons a back or spine surgery may fail, there are a number of specific considerations based on the surgery performed that contribute to the return of pain or the failure of the surgery.
Lumbar Decompression Back Surgery (disc herniation or spinal stenosis): Inadequate decompression of the nerve, prior damage to the nerve that isn’t healed through surgery, or nerve damage occurring during surgery can all lead to the re-emergence of pain.
Scar Tissue Formation: Patients who have the formation of scar tissue around the treated nerve root can experience a re-emergence of pain. This is known as post-laminectomy syndrome and is typically extremely frustrating. If the scar tissue is removed, it will typically just come right back.
Failed Spinal Fusion: If a fusion fails to occur, the implanted hardware continues to absorb stress and may eventually break. Pain usually goes “through the roof” when that happens.
Adjacent Segment Degeneration – this is an interesting phenomenon. Fusion occurs as desired at the operative level, then the adjacent levels see increased stress. This leads to accelerated breakdown, which leads to increased pain.
The symptoms of Failed Back Surgery Syndrome
Many patients will experience a reappearance of symptoms similar to the original condition, located either in the same area of the back or spine or in an area near to the original if the injury has shifted a spinal level.
Pain may radiate into the flank or buttocks, and potentially into the thighs. If a nerve root was either not freed up well, or develops scar tissue around it, an individual may develop unrelenting pain down a person’s leg.
How is post-operative pain in Failed Back Surgery Syndrome diagnosed?
The workup for FBSS includes several diagnostic methods:
History and Physical Exam
CT Scan and/or MRI
Possibly a nerve conduction study
Possibly a diagnostic injection (e.g. around a person’s hardware)
Treatment options for Failed Back Surgery Syndrome
The treatment of post-surgery pain should be approached as a systematic process of elimination. To do this, each pain generator is identified and eliminated until the symptoms fade for the patient and function of the spine or back is restored.
Several treatment possibilities with pain management clinics in San Antonio include:
Oral or Topical Pain Medications
Neurogenic Medications such as Lyrica or Neurontin
Injections – Trigger Point Injections, Facet or medial branch blocks, Epidural Steroid Injections, injections around one’s hardware.
Procedures – A Spinal cord stimulator implant may provide excellent pain relief as a last resort. This is especially helpful when a person has no further surgical options, as the spinal cord implant helps over 75% of patients obtain satisfactory relief.
If you or a loved one is suffering from Failed Back Syndrome and would like the best pain treatment in San Antonio, call Texas Pain Network today. The practice has a Double Board Certified pain management doctor accepting over 50 insurance plans at multiple locations.
Call (210) 202-4030 for more information and scheduling!