Back & Neck Conditions
What is Failed Back & Neck Surgery?
Spine surgery is commonly performed to treat neck and back pain. Surgical operations are typically performed to achieve spinal decompression; and hardware such as cages, bone grafts, bars, and screws are sometimes used. In some cases (either due to unforeseen consequences, behavior, or surgical error) pain or numbness can remain or re-appear post-surgery.
- If a patient continues to experience pain or symptoms of a back and/or leg condition, the patient is then said to have failed spine surgery syndrome.
- If the symptoms are present in the neck and arms, it is considered failed neck surgery syndrome.
Failed back and neck surgery types
In the case of a failed laminectomy (also known as Post Laminectomy Syndrome), continuous chronic pain indicates surgical failure. After a section of bone is removed from the spine during the laminectomy, scar tissue can sometimes form. Painful, inflamed joints at the surgical site are another possible outcome.
Whether it is failed back surgery syndrome or failed neck surgery syndrome, the condition might be due to several different factors such as:
- An incorrect diagnosis
- Poor patient selection by the center
- Incomplete decompression
- Inadequate surgical skill and experience of the surgeon
Adjacent segment disease can result after spinal fusion. A person can have symptoms like radiating pain, and neurological symptoms such as tingling, numbness, weakness, and pain while walking. Artificial disc neck surgery is usually performed to treat disc herniation. Such a condition doesn’t cause pain itself, but it can put excess pressure on nerves, which then can cause pain or other unpleasant sensations. One of the surgery risks is a bone fracture or erosion, which can result in a misalignment of the vertebrae.
A laminectomy targets relieving pressure on the spinal cord or nerves by removing a piece of bone on the back of the vertebrae. Such surgery can result in a less stable spine or a nerve injury.
Laminoplasty surgery is similar to laminectomy, but a surgeon inserts an implant to hold bones on the back of the vertebrae, which can end up not working, or the degenerative changes progress.
Spinal fusions are very common. During this surgery, two vertebrae are joined together with metal devices, which can lead to a loss of flexibility.
Failed back and neck surgery symptoms
The most obvious failed back surgery symptom is chronic back or neck pain.
Other symptoms may differ due to the type of surgery and the diagnosis, but they include:
- Chronic pain for 12+weeks;
- Localized dull or sharp pain immediately after the surgery;
- Neuropathic pain caused by nerve damage, which shows numbness, burning, tingling, or weakness;
- Radiculopathy aka pain radiating from one area to another.
A person can also experience the original symptoms that return after a failed surgery. Some symptoms like reduced mobility and headaches can greatly disturb normal activities
Failed back and neck surgery syndrome diagnosis
The diagnosis of a failed back and neck surgery is usually performed in several phases. The first is medical history. For a physician to diagnose a failed back and neck surgery, they need to look at a few different aspects of your pain. The medical history of the patient is taken into account, along with a physical examination. If deemed necessary, diagnostic tests will also be ordered.
The medical history of the patient will help describe when the pain started, what the patient was doing that caused it, and what the pain feels like. You can be asked questions like “Is it a burning sensation?” “Does it radiate to the arms?” “Does it feel less intense in one position rather than the other?”
During the physical examination, the physician will test for nerve function, as well as how strong the muscle is in certain areas of either the arm or leg. The physical manipulation tests that are performed should give your doctor a good idea of your condition.
An accurate diagnosis often involves using a variety of imaging tests and tools:
- X-rays, which show the structure of spinal vertebrae and the outline of spinal joints
- MRI, CT, and PET scans, which produce images of the spine.
- Angiography, which obtains detailed, 3-dimensional images of blood vessels surrounding the spine.
- Myelography, which is a diagnostic imaging test to assess the issues in the spinal cord, nerve roots, other tissues.
Failed back and neck surgery syndrome treatment
A spine surgery failure can be devastating, but there are ways to reduce the negative effects. First of all, your doctor can create a multidisciplinary back pain treatment plan, which involves several types of treatments to give you the best outcome possible. Such a plan can have a second surgery, physiotherapy, physical exercises, and medications to reduce pain and restore the ability to function and return to normal activities.
Back pain treatment options include transcranial magnetic stimulation, spinal cord stimulation, injection therapy, including trigger point injection and epidural steroid injection; and radiofrequency ablation. Some alternative treatment options such as acupuncture can also be offered.
Failed back and neck surgery syndrome prevention
To help patients reduce the chance of developing failed back syndrome, Atlantic Spine Center has developed several state-of-the-art medical procedures that:
- Are minimally invasive
- Do not require large incisions or hardware insertion
- Produce high rates of success with low risks of complication
- Offer long-lasting pain relief
- Allow a rapid recovery time
So it’s very difficult to prevent failed back syndrome. In fact, the only way to truly avoid failed back or neck surgery syndrome is by avoiding surgery, especially open back or neck surgery. However, this will be a difficult decision to make if surgery is the only effective treatment option available for your back pain. In this case, you are left with the choice of either living with pain indefinitely, or having surgery that may or may not improve your condition.