Spinal surgery is one of the most commonly turned to treatments for back pain. Back pain can arise for a number of reasons, and when the injury is severe enough, it can affect your arms or legs as well. While surgery can be helpful and address the root problem of the pain, there is also a chance that a spinal surgery does not completely heal the injury and that back pain may continue after the surgery. This phenomenon is known as failed back surgery syndrome, and it is not necessarily a result of the surgery itself. However, it does cause persistent pain and other possible complications following surgery.
What is Failed Back Surgery Syndrome?
Failed back surgery syndrome, or FBSS, is referred to as pain that may be persistent or new and occurs following a spine surgery procedure. Now, this isn’t to say that all cases of FBSS are a result of a failed surgery. This syndrome simply refers to individuals that have had back surgery in the past and continue to experience pain and negative symptoms following the procedure. In fact, nearly 40 percent of those who have undergone surgery to address back pain have experienced pain afterward. This pain may not be evident right away and may take months to present itself.
Sometimes after back surgery, a person may feel that the pain gets better and alleviates for a period of time. But after a while, it may begin to worsen again. In other cases, the pain may never get better after surgery or may even become worse. This change may be noted in the intensity of the pain or its location. Sometimes, back pain may be felt solely in the back or leg prior to surgery, but afterwards, it may manifest itself in the other location or both.
Post-surgical pain can occur for a number of reasons. One of the most common procedures resulting in FBSS is spinal fusions. This procedure involves using bone grafts, screws, plates, and other hardware to hold two or more vertebrae together. This prevents any movement of that spinal joint and, in theory, eliminates pain caused by intervertebral disc degeneration or spinal nerve compression.
While the idea behind this procedure is solid, there is always the chance that complications may occur. For example, even if the graft and fusion are successful in solidifying the joint, the lack of motion from that joint could cause compensations in other areas of the spine and result in the same injury, pain, and discomfort as before in another joint.
Additionally, the fusion itself could be defective. The bone graft could fail to connect to the existing bone, or the screws and plates could work themselves loose or break all together. Each of these situations could cause recurrent issues in the spine or affected limbs.
Possible Treatments for FBSS
If you do suffer from FBSS, there are a few treatments that are commonly used to try to address the pain. Some of these include spinal injections, nerve blocks, or other treatments that work to dull or block the pain stemming from a certain area of the spine. Additionally, strength training or physical therapy programs may be used to try to eliminate muscular compensations and relieve pressure on problematic areas of the spine.
If these initial treatment options do not work, more aggressive options may be pursued. One of these methods involves neuromodulation using electrical currents. The idea behind this therapy is that an electrical contact that is placed near the affected spinal nerves may prevent the nerve from transmitting painful stimuli to the brain, which would effectively alleviate pain. If successful in the trial stage, a small battery can be implanted in the affected area to constantly produce stimulation and alter nerve functionality.
Further surgical procedures may also be used to try to address the pain. This can include spinal fusions, intervertebral disc replacements or removal, removal of parts of the bony vertebrae, and others. But, each of these follow-up procedures carries the same risk as the original procedure. There is always the chance that the surgery may not truly address the root cause of the pain. Additionally, compensation could occur and result in another issue at a different point in the spine.
FBSS is a common issue for patients that have undergone surgery to address their back pain. Surgical procedures on the spine can be difficult to heal from and do not carry as high a success rate as surgeries in other areas of the body. When dealing with back pain, it is important to weigh all of your options before deciding on a certain path for treatment. Surgical procedures can be effective in some cases, but there is always the chance of complications and the need for further therapy and treatment afterward.