What is Failed Back Surgery Syndrome?
Failed Back Surgery Syndrome (FBSS) is the general term for continuing chronic pain after a spinal surgery that was meant to relieve it. The pain may feel the same as before surgery or entirely different. FBSS usually results from a combination of factors rather than a single cause, which is why careful re-evaluation is essential when pain persists after an operation. At NextGen Spine Center, correcting previously failed procedures, including failed fusions, is one of the things we do most.
Types of Failed Back Surgery
Persistent pain: The original problem was not fully corrected, or the wrong level or diagnosis was treated.
Recurrent pain: Symptoms improved and then returned, often from a recurrent disc herniation or scar tissue around the nerve.
New pain: A different problem developed after surgery, such as adjacent segment disease above or below a fusion, or irritation from implanted hardware.
Causes
Common causes include:
– Incomplete decompression or surgery at the wrong level
– Scar tissue forming around the nerve
– Recurrent disc herniation
– Adjacent segment disease after fusion
– Loose, painful or failed hardware
– Fusion that did not heal (pseudarthrosis)
– An incorrect original diagnosis
Symptoms
Symptoms may include:
– Back or neck pain that never improved, or returned after surgery
– New radiating pain, numbness or tingling in an arm or leg
– Pain or prominence at the hardware site
– Stiffness and reduced mobility
– Weakness or difficulty walking
Diagnosis
Evaluation typically involves:
– A detailed review of the previous surgery and operative reports
– Physical and neurological examination
– X-rays to assess alignment, fusion and hardware
– MRI or CT to identify scar tissue, recurrent herniation or nerve compression
– Diagnostic injections to pinpoint the pain source
Managing Symptoms
Living with pain after surgery is discouraging, and many patients are told there is nothing more to be done. In most cases that is not true. Symptoms can often be managed in the short term with physical therapy, medication and injections, but persistent pain after surgery deserves a fresh, independent evaluation. Bring your imaging and operative reports; identifying the specific reason the first surgery did not work is the key to correcting it.
Prevention
The best protection against failed back surgery is choosing the right procedure the first time: an accurate diagnosis, treating only the level that is causing symptoms, and preserving as much healthy tissue and natural motion as possible. Avoiding fusion and implanted hardware whenever it is not truly necessary removes two of the most common sources of long-term problems.
Conservative Treatment Options
Non-surgical options include:
– Physical therapy and core strengthening
– Anti-inflammatory and nerve pain medications
– Epidural steroid or facet joint injections
– Activity modification and ergonomic changes
– Pain management techniques such as radiofrequency ablation
Surgical Treatment Options
When a specific, correctable cause is identified, revision surgery can be very effective, and it does not have to mean another large operation. At NextGen Spine Center we correct failed procedures using minimally invasive techniques: decompression of nerves left compressed by scar tissue or recurrent herniation, treatment of adjacent segment disease without extending the fusion, and removal of painful or loosened hardware. Procedures are performed through small openings on an outpatient basis, and patients return home the same day. Learn more about how we correct failed back surgery.
Frequently Asked Questions
Or contact us at any time
Some soreness during recovery is normal, but pain that persists for months, returns after improving, or is different from your original pain should be evaluated. It usually has an identifiable cause.
Often, yes. Depending on the cause, treatment may involve decompressing a nerve that is still compressed, treating the level above or below the fusion, or removing hardware that has become painful, all of which we perform minimally invasively.
At NextGen Spine Center our goal is to avoid fusion and implanted hardware whenever possible. Most revision procedures we perform preserve the natural motion of the spine.
Your most recent MRI or CT, X-rays, and the operative report from your previous surgery. These allow us to determine exactly why the first procedure did not relieve your pain.
Correcting failed back surgery is one of our specialties. We offer an independent evaluation of your imaging and a treatment plan built around truly minimally invasive procedures, designed to help our patients return to a pain-free life without further fusion or hardware.