Nobody likes the idea of failure, so the term “failed back syndrome” is enough to dim the mood of anyone still suffering with back or neck pain after undergoing surgery that was supposed to fix the problem. But all is not lost for these patients and many approaches still offer hope for effective pain relief, says Praveen Kadimcherla, MD, an orthopedic spine surgeon at Atlantic Spine Center.
Failed back syndrome, also known as failed back surgery syndrome, is not actually a syndrome at all. It’s a term describing patients who haven’t experienced successful spine surgery and still cope with persistent pain in its aftermath, Dr. Kadimcherla says.
“Many reasons may explain why a back or neck surgery might not work, and even with a top-notch surgeon and the best indicators for a surgery’s success, about 5% or more of spine surgeries don’t offer a pain-free result,” says Dr. Kadimcherla, who is fellowship-trained in orthopedic and spine neurosurgery.
Why back pain can persist after surgery:
Sharp or dull pain that remains many months after a patient heals from normal surgical pain – from an incision, or stretched muscles and tissues – can offer a clue that they’re in the distinct minority who are dealing with failed back syndrome, Dr. Kadimcherla says. Since surgery is only performed after more conservative measures, such as medications or physical therapy, don’t work, it can be extremely disheartening to realize that the trauma, scarring or hardware used in spinal surgery, such as bone grafts and screws, may have led to chronic back or neck discomfort.
Other reasons for failed back syndrome include:
- Inaccurate original diagnosis
- Inappropriate choice of surgery
- Nerve damage
- Incomplete bone removal
- Residual disc herniation or recurrent disc herniation
- Misaligned hardware in the spine
- Improper fusion after spinal fusion
- Breakdown above or below an operated area
- Scar tissue formation
“Many of the factors leading to a poor result from spine surgery aren’t preventable, and choosing to undergo surgery was likely a difficult decision,” Dr. Kadimcherla says. “So when pain lingers afterward, it can be highly discouraging. Luckily, pain doesn’t have to get the last word.”
Tips for tackling failed back syndrome:
Dr. Kadimcherla’s top tip for tackling failed back syndrome? “Get a diagnosis – a physical reason for your ongoing pain,” he states. “MRI and CT scans can point to specific reasons pain is continuing, and can steer doctors toward treatments targeting those distinct causes.”
Occasionally, another surgical procedure may be recommended for more permanent relief. Endoscopic spine surgery, which offers a minimally invasive approach, can represent a less complicated, less risky solution. “As hesitant as you may be to consider surgery again, someone with failed back syndrome can be an excellent candidate in the hands of an experienced endoscopic surgeon,” he says.
A variety of nonsurgical treatment options may also reduce or eliminate pain for someone with failed back syndrome. These include:
- Steroid injections
- Nerve blocks
- Physical therapy or exercise
- Over-the-counter or prescription pain relievers
- Spinal cord stimulation, a device emitting electrical impulses into the problematic region
“A combination approach is often most effective,” Dr. Kadimcherla suggests. “Just don’t give up. Usually, pain can be very well managed with a correct diagnosis and a well-considered treatment plan.”
Featured in HealthNewsDigest.com: Failed Back Syndrome Treatment