Back Surgery and Why It May Not Relieve Your Pain
You expect your back or neck problem to be resolved after spine surgery. However, that isn’t always true. A condition known as failed back surgery syndrome (FBSS) occurs when symptoms reappear after surgery, whether immediately or months later. As a result, your doctor must manage the symptoms of failed back surgery syndrome (FBSS) and help you with your recovery.
Patients with failed back surgery syndrome (FBSS) experience new or enduring pain after spinal surgery. There may be lingering discomfort in the surrounding tissues and muscle spasms after surgery, resulting in lessened pain, but over time, it may worsen. This may indicate problems with the procedure or failure to heal as expected.
There are several symptoms associated with failed back surgery syndrome:
- Chronic pain
- Inflammatory symptoms, including numbness, weakness, and tingling
- Pain in the legs
- Radiating pain from one part of the body to another, such as from the neck to the lower back
- Reduced mobility
- Return of original symptoms
- Headaches, if you had cervical surgery
After spine surgery, many factors can influence the likelihood that you will experience failed back surgery syndrome. These factors may happen before, during, and after your surgery.
Risk factors for FBSS before surgery
These issues can indicate a higher risk for failed back surgery syndrome and should be addresses by the surgeon prior to surgery:
- Psychiatric and emotional problems like anxiety and depression
- Weight gain
- Pain brought on by other ailments such as fibromyalgia
Risk factors for FBSS during surgery
Failed back surgery syndrome may result from these parts during surgery:
- Insufficient decompression of the spinal cord
- Excessive decompression causing spinal instability when you create too much space around nerves
- Misplaced surgery is when the surgeon operates on the wrong part of the spine. It happens in about 2.1% to 2.7% of cases, and more often with minimally invasive surgery.
Risk factors for FBSS after surgery
Back surgery can fail for one or more of the following reasons following surgery:
- Recurrence of the original condition, such as recurrent disc herniation
- Adjacent segment disease (ASD) occurs after spinal fusion when the level above a fusion is under more stress and degenerates faster
- Epidural fibrosis caused by scar tissue encasing nerve roots
- Infection in the spine
- Problems with balance in the spine, called sagittal imbalance, that speed up degeneration
- Radiating pain from irritation of the spinal nerve root after surgery
- Pseudoarthrosis as a result of the screws loosening due to a lack of fusion
As you recover from spine surgery, it’s challenging to determine whether your discomfort is normal. Your spine surgeon should be able to see how your recovery is going. In addition, they can address any concerns you may have during your regular follow-up appointments.
Even though spinal surgery can cause pain, some signs and symptoms need immediate attention. If you notice any of the following warning signs, get in touch with your doctor right away:
- Weakness and difficulty walking along with sharp pain in your lower body
- Insomnia caused by pain at night
- Unintentional weight loss, nausea, and fever
- Bowel or bladder dysfunction-This could be a sign of cauda equina syndrome, a severe spinal nerve disorder
A diagnosis of FBSS requires your doctor to link your current spinal issue to your previous spinal surgery. Your doctor may use technologies like CT scans, MRI scans and X-rays to diagnose your condition. For instance, the cause of back pain you experience five years after surgery might be age-related wear and tear on your spine.
Even after a failed surgery, specific treatments may relieve discomfort and enable you to return to normal activities. Rather than relying solely on one treatment such as surgery, your doctor may recommend a combination of therapies to relieve your pain completely.
Medications may help you manage your pain. Initial treatments include injections, nerve blocks, and radiofrequency neurotomies. Directly injecting painkillers into the part of the body experiencing discomfort may be more beneficial than oral dosing due to the need for less medication and fewer side effects.
Electrified neurostimulation can help with pain caused by nerves other than the spine. The stimulation is continued if the patient experiences pain relief, using a tiny battery similar to that found in heart pacemakers.
Your doctor might also suggest that you seek the help of a physical therapist for regaining function or a behavioral health specialist for mental and emotional recovery.
A failed back surgery may result in different symptoms for each patient, depending on their surgical experience. Revision surgery requires a specific set of skills and experience. If you are concerned that your back surgery was not successful, we strongly recommend getting a second opinion. To schedule an appointment with Dr. Butler, complete our contact form.