Fact on Failed Back Surgery Syndrome (FBSS)
If you choose to have back surgery, there is a high chance that it will be only partially successful. While around 600,000 people have back surgery each year in the U.S., many of these people do not have positive results (up to 40%). Failed back surgery syndrome (FBSS) is a medical term used to describe continued back pain after surgery.
What are the symptoms associated with failed back surgery syndrome?
Most people choose to have back surgery to relieve pain. There are many reasons why a person has chronic pain after a spinal procedure. FBSS involves multiple symptoms, such as chronic back pain, as well as leg symptoms (burning, numbness, and/or tingling). Symptoms often vary in severity and can include:
- Pain at a new level different from the pain associated with the location treated
- Inability to get better
- Sharp, stabbing pain
- Aching, dull, and constant pain
- Numbness that radiates to the lower back and into the legs
- Restricted mobility
- Muscle spasms
- Sleeplessness, anxiety, and/or depression
What are the categories of Failed Back Surgery?
Failed back surgery patients fall into one of three distinct categories. These are:
- Category 1 – Patients who have back surgery for the wrong reasons. An example is the patient who has degenerative disc disease with a fusion at a suspected level who does not have symptoms related to that level.
- Category 2 – Patients who have a legitimate reason for surgery, but the procedure is inadequately or incorrectly performed or the desired outcome is not achieved. Even if the surgery is done correctly, a patient does not always achieve pain relief.
- Category 3 – Over time, degeneration occurs in the area around the surgery. An example is when a patient has a fusion with excellent results, and the vertebrae above or below it breaks down.
How common is failed back surgery syndrome?
Based on a 2004 FDA clinical trial, 50% of patients who had spinal fusion surgery and artificial disc replacement continued to use narcotic medications one year or more after the procedure. Spinal fusion is the gold standard for degenerative disc disease that has failed to respond to conservative treatment.
What causes failed back surgery syndrome?
The pain associated with FBSS is often related to scar tissue, which forms in the areas where the surgery was done. Scar tissue can cause pain when nerve roots are irritated, which also leads to leg symptoms. Changes occur inside the nerve root when scar tissue forms around these structures, and this results in chronic leg pain. Other causes of FBSS include operating on the wrong area, failure to fuse properly, and recurrence of spinal stenosis.
What is the most common cause of pain following back surgery?
The most common reason people have pain following an initially successful back surgery is adjacent segment degeneration. When a level cannot absorb stress, which occurs with fusion, this stress can go up or down the spine, causing accelerated degeneration pain. More than 20% of patients who have spinal fusion procedures end up needing an additional surgery.
Will revision surgery help?
It may be necessary for a patient to have revision surgery in the case of failure of fusion or recurrent disease. This procedure is more complicated due to the presence of scar tissue. The chance of a good outcome improve when the patient works with a physical therapist to strengthen the back and core muscles.
For those suffering from failed back surgery syndrome in the greater Chicago area, Premier Pain & Spine offers comprehensive treatment options. Over 25 treatment options are available, which may include both medication management and interventional therapies.
For the top pain treatment in Chicago, call us today!