Failed back surgery syndrome: What it is and how to avoid it
Failed back surgery introduction
Failed back surgery syndrome describe the condition of patients who have not had a successful result with back surgery or spine surgery.
There are many reasons that a 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.
Spine surgery is only basically able to accomplish two things:
- Decompressing a nerve root that is pinched, or
- Stabilizing 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.
By far the number one reason back surgery is not effective is because the lesion that was operated on is not in fact the cause of the patient’s pain.
Some types of back surgery are far more predictable in terms of alleviating a patient’s symptoms than others. For instance,
- A discectomy (or microdiscectomy) for a lumbar disc herniation that is causing leg pain is a very predictable operation. However, a discectomy for a lumbar disc herniation that is causing lower back pain is far less likely to be successful.
- A spine fusion for spinal instability (e.g. spondylolisthesis) is a relatively predictable operation. However, a spine fusion for multi-level lumbar degenerative disc disease is far less likely to be successful in reducing a patient’s pain.
In addition to the above-mentioned cause of failed back surgery syndrome, there are several other potential causes of a failed surgery, or continued pain after surgery:
- Fusion surgery considerations (such as failure to fuse and/or implant failure, or a transfer lesion to another level after a spine fusion, when the next level degenerates and becomes a pain generator)
- Lumbar decompression back surgery considerations (such as recurrent stenosis or disc herniation, inadequate decompression of a nerve root, preoperative nerve damage that does not heal after a decompressive surgery, or nerve damage that occurs during the surgery)
- Scar tissue considerations (scarring tissue can wrap itself around the nerve becoming a constant source of pain)
Therefore, the best way to avoid a spine surgery that leads to an unsuccessful result is to stick to operations that have a high degree of success and to make sure that an anatomic lesion that is amenable to surgical correction is identified preoperatively.
Research indicates that chiropractic manipulation combined with specific strength and stabilizing rehabilitation exercises have a higher chance of easing and correcting your cause of pain than medication or physical therapy alone. Holmes Spine & Sport also utilizes an active spinal decompression table to release nerve pressure and help heal herniated disc and sciatica pain.
Chiropractic and other conservative care treatments can still be effective even when surgery has failed to relieve the pain . Holmes Spine & Sport Chiropractic provides a number of conservative treatments which makes it easier to get the care you need. We also work with your family physician and orthopedic surgeon.