Failed Back Surgery Syndrome and the Success Rate of Spinal Surgery
With around one in ten people experiencing the condition, back pain is a leading cause of disability around the world. From stabbing, shooting sensations to chronic aches and pains, a bad back can significantly interfere with work, your quality of life, and enjoyment of everyday activities. You might even find yourself withdrawing socially because you don’t want to deal with the repercussions of leaving the comfort of your home.
Many patients turn to surgery for relief of their pain. Unfortunately, sometimes the procedure does not achieve its goals. This is often referred to as FBSS, or Failed Back Surgery Syndrome.
What is Failed Back Surgery Syndrome?
FBSS is defined as any chronic or persistent pain that was not relieved through prior spinal surgery. Clients usually feel like their surgery relieved some of their symptoms but not all, or that it only provided relief temporarily. In some cases, patients may even feel that their pain worsened after surgery or that the pain only migrated to a different area of the body.
What are some of the underlying causes of pain that comes back after surgery?
After spine surgery, there is a period of time when the spine has not fully healed. The patient’s bones may fail to fuse or join together properly, preventing the screws and rods used to secure their injury from functioning effectively long-term. In this small population, pain may continue after surgery, migrate to another area of the body, or even get worse.
Another underlying reason for continued discomfort after back surgery may be further degeneration of the body. In this case, the original surgery didn’t fail but merely wasn’t able to address the full scope of the patient’s disease, which has only continued to worsen over time. One area of the spine may have improved, but the regions above and below that spot may continue to devolve. This is called adjacent segment disease or breakdown.
What treatments can be undergone at this point?
Determining the next course of action after back surgery with outstanding, unaddressed pain is a complex journey. It will be important to determine whether the discomfort is related to the old condition or whether a new ailment in the spine is surfacing, either above or below the original point of injury.
Some patients may experience relief for years, only to suddenly find themselves suffering a similar problem at a different area of the back. They have the option to undergo another surgery or begin again with conservative treatments such as medication, physical therapy, and injections. It is a personal choice and one that can be discussed in depth with your spine specialist.
What is SCS therapy?
SCS (Spinal Cord Stimulation) therapy is a treatment to prevent pain signals from reaching the brain. When other options have failed to lessen chronic pain, SCS may help provide relief. A small implant is placed within the body that delivers electric pulses to the spinal cord nerves, masking their message of distress to the brain. The system can be turned on and off, and the strength of the stimulation can be increased or decreased as needed. With SCS, the pain remains, but the brain may not experience it as harshly as before.
What is the takeaway?
Regardless of your surgical history, it’s essential to receive a diagnosis that pinpoints the underlying causes of your pain. Imaging studies can be performed, along with nutritional assessments and laboratory tests. However, complex testing cannot take the place of a face-to-face examination and a frank discussion of symptoms.
It’s important to understand that you have options for managing chronic pain. Undergoing additional surgeries is a possibility, but there are also non-surgical routes to explore, including medication, injections, physical therapy, and SCS. As a top spine surgeon in NYC, Dr. Stieber will go over the pros and cons of each choice with you and help you determine the next best steps. While it’s easy to feel frustrated when your back surgery did not go the distance to combat your symptoms, don’t give up completely on finding a solution. A better quality of life may be just around the corner.