Failed Back Surgery: What do I do now?

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The decision to go under the knife is a life changing one. Especially when the goal is to relieve chronic pain that has been a hindrance to your life. So it can be extremely upsetting when the surgery fails. Failed Back Surgery Syndrome (FBSS), is a condition where the patient does not have success after back or spine surgery and is still experiencing pain. There are many reasons the pain persists but the most common are explained below.

Adjacent Segment Disease

When having a fusion surgery it mimics a broken bone trying to heal. Bone cells travel from the roughened bone over the bone graft to other roughened areas and form solid bone. This process takes about a year for the solid bone to form. This is also known as bone fusion. When you have spinal fusion surgery there is the possibility it could fail, which can lead to chronic pain. The reasons it might fail are poor placement of screws or rods, use of anti-inflammatories, or activities with excessive motion. These reasons can cause the fusion to not occur at all or cause a failure of the implant. Over time a successful fusion can also start to breakdown and become a new source of pain.

Epidural Fibrosis

This is the formation of scar tissue near the nerve root. Although scar tissue has no nerve endings and cannot cause pain, when it is near a nerve root it can apply pressure to it causing pain. Pain usually starts to occur about 6 to 12 weeks post-surgery. Since scar tissue is slow it form there will be initial pain relief following the back surgery. But as the scar tissue begins to form the pain relief subsides and pain levels increase. Feeling a burning pain or a constant gnawing pain can be an indicator of epidural fibrosis.

Decompression Surgery Failure

A decompression surgery can be a laminectomy or a discectomy. In most cases, the patient will feel back to normal after three months. If the patient is not feeling pain relief after these three months, improvement is not likely to happen. There are three possible technical problems that can generate pain after decompression surgery.

  • Surgery was done at the wrong level of the spine
  • Further trauma occurred during the dissection of the nerve root
  • A bone or missed fragment of the disc is still pinching the nerve

When decompressing a nerve root there is chance that it will create more inflammation and lead to greater pain until the inflammation subsides. Spinal Stenosis can also come back following a decompression surgery, at the same or greater level, producing pain.

Arachnoiditis

This refers to the inflammation of the arachnoid. This is a delicate membrane that protects and surrounds the nerves of the spinal cord. Inflammation can lead to the formation of scar tissue and cause the spinal nerves to stick together and malfunction. One of the reasons the arachnoid becomes inflamed is back or spinal surgery. If the inflammation is not treated right away or correctly it can prompt chronic pain and damage the nerve roots. Those who suffer from arachnoiditis are unable to participate in everyday life from the debilitating pain. Symptoms include numbness, tingling, weakness, stinging, and burning in the legs.

 

If you have had back surgery and it is failing you, it is time to consult a Pain Management physician to get your pain under control. IMS Pain Management has all the right tools and experience to treat your chronic pain. We specialize in getting our patients back into a pain-free life in the most painless way possible. Schedule an appointment today!

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