Failed Back Surgery Syndrome

What is failed back surgery syndrome?

Failed back surgery syndrome (also called FBSS, or failed back syndrome) is a misnomer, as it is not actually a syndrome – it is a very generalized term that is often used to describe the condition of patients who have not had a successful result with back surgery or spine surgery and have experienced continued pain after surgery. There is no equivalent term for failed back surgery syndrome in any other type of surgery (e.g. there is no failed cardiac surgery syndrome, failed knee surgery syndrome, etc.).

There are many reasons that a back surgery may or may not work, and even with the best surgeon and for the best indications, spine surgery is no more than 95% predictive of a successful result.

What are the causes?

Spine surgery is basically able to accomplish only two things:

  • Decompress a nerve root that is pinched, or
  • Stabilize a painful joint.

Unfortunately, back surgery or spine surgery cannot literally cut out a patient’s pain. It is only able to change anatomy, and an anatomical lesion (injury) that is a probable cause of back pain must be identified prior to rather than after back surgery or spine surgery.

By far the number one reason back surgeries are not effective and some patients experience continued pain after surgery is because the lesion that was operated on is not in fact the cause of the patient’s pain.

What are the symptoms?

The most obvious symptom of failed back surgery syndrome is persistent, chronic pain that is not associated with the healing process. Other symptoms associated with FBSS include:

  • New pain at a level different from the location treated
  • Inability to recuperate
  • Restricted mobility
  • Sharp, stabbing back pain
  • Numbness or pain radiating through the lower back into the legs
  • Back spasms
  • Anxiety, depression and sleeplessness
  • Potential dependence on pain medication

What are the treatments?

Treatment for failed back surgery syndrome may include physical therapy, nerve blocks, medications, injections or a chronic pain management program. If the pain is possibly coming from the facet or sacroiliac joints, chiropractic care may be used. Correctable structural problems are sought and, if identified, surgery may be performed to address these issues with Failed Back Syndrome. This may include facet joint or sacroiliac joint rhizotomy. Sometimes no correctable cause of the patient’s symptoms with Failed Back Syndrome is identified. In these cases, spinal cord stimulation (SCS) or narcotic pumps may be used for pain control. It is important to discuss treatment options with your doctor in deciding which treatment, if any, may be best for you.

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