What is failed spine surgery syndrome and what options are there for it?
If back or neck surgery fails, there are still many good options for pain relief.
It’s never a casual decision to undergo back or neck surgery. So, when this more invasive treatment approach fails to alleviate chronic pain, a situation dubbed “failed spine surgery syndrome”, what can you do next? Fortunately, many treatment options can still save the day, according to Kaliq Chang MD, Interventional Pain Management Specialist with Atlantic Spine Center.
More than 600,000 spine surgeries happen in the United States each year, but only about 5% of patients undergoing these procedures still have significant, lingering pain after the operation and recovery period, explains Dr. Chang, who is fellowship-trained in orthopedic and spine neurosurgery. While no type of surgery works every single time – whether in the spine or another part of the body – it’s undoubtedly disappointing and distressing for patients whose back or neck surgery fails, as well as their surgeons.
“Symptoms of a failed back or neck surgery can include back, leg, or arm pain that’s dull and aching or sharp and stabbing, along with tingling, numbness, or muscle weakness,” he says. “The vast majority of back or neck surgeries, however, succeed in decompressing nerve roots that are pinched or in stabilizing painful spinal joints that led to the chronic pain, numbness or weakness in the first place.”
Reasons surgery might not work
Why might back or neck surgery fail? It’s a vexing question and one with many possible answers, Dr. Chang says. These include:
- Significant trauma, scarring and hardware used in and around the surgical site
- Inflamed joints at the surgical site
- Lingering disc herniation
- Undue stress on another weakened portion of the spine from the recovery process
- Improper fusion after spinal fusion
- Misaligned spine hardware
- Incomplete bone removal
- Disc space infection
- Nerve damage
- Inaccurate diagnosis of original problem
“Whatever the reason for failed back or neck surgery, it’s important to point out that failure doesn’t mean you’re stuck with pain forever,” Dr. Chang notes. “Patients and doctors can and should work together to overcome the obstacles and find another solution that works.”
Other treatment options
How do you move forward after back or neck surgery that doesn’t work? With optimism, Dr. Chang advises. “Today more than ever there are many other treatments for pain, besides further surgery, and alternatives, other than more injections,” adds Dr. Chang.
The first step is ensuring your spinal diagnosis is correct. To accomplish this, your doctor will use a variety of tests and tools that may include X-rays, MRI or CT scans, and nerve blocks or other injections. Once the cause of your ongoing pain is revealed, it will likely be tackled using a blend of several treatment approaches, he says. These can include:
- Exercise or physical therapy
- Epidural steroid injections
- Nerve blocks
- Psychological counseling
- Spinal cord stimulation using a device that sends electrical pulses into the spine area
- Revision surgery
“It’s understandable to feel frustrated and defeated if your back or neck surgery doesn’t work, but it’s more than worth it to pursue a more precise diagnosis and appropriate treatment course,” Dr. Chang says. “Be persistent and talk to your doctor.”