Failed back surgery syndrome, (FBSS) is a term referring to the chronic and severe pain a patient can experience after unsuccessful surgery. FBSS affects up to 40 percent of patients who have had traditional open back or minimally invasive spine surgery. Often surgery is indicated for an identifiable source of pain due to pinched nerve root or an unstable and painful joint. However, back pain can have many causes and accurate identification of the source of pain is complicated. Too often an x-ray and Magnetic resonance imaging (MRI) scans does not correlate well with symptoms. Therefore, diagnostic injections are often warranted and assist in making the proper patient selection and spinal level for surgery.
What Causes Failed Back Surgery Syndrome?
Failed back surgery syndrome can result from one of many causes such as:
What are the symptoms of Failed Back Surgery Syndrome?
The pain associated with failed back syndrome varies depending on the surgical procedure performed and the conditions treated. The pain can range from a dull ache to sharp stabbing pain and may be localized to one area of the back or reach into the legs. Patients suffering from FBSS can experience any of the following symptoms:
How is Failed Back Surgery Syndrome Diagnosed?
Accurate and thorough diagnosis is key to selecting the best treatment options. The following is part of a comprehensive diagnostic workup:
What Are The Treatment Options For Failed Back Surgery Syndrome?
Treatment of failed back surgery syndrome and chronic pain is difficult. In order to accurately diagnose FBSS a complete history and symptoms the patient is experiencing. It is also important to get a new MRI or CT Scan and do diagnostic injections to better understand what is causing the pain and pinpoint the affected area.
Once conservative measures have been exhausted and the patient is still in considerable pain after 6 months then minimally invasive procedures may be recommended. The following procedure has shown great results in alleviating pain altogether and returning patients to work and life sooner than traditional spine surgery.
Most minimally-invasive patients can begin getting out of bed hours after surgery and go home shortly afterward. With a MIS spine fusion, the time for post-operative recovery is longer and may involve overnight stay in the hospital. Activity is gradually increased and patients are typically able to return to work within a few days to 2 weeks depending on the type of surgery and job description. With a spine fusion return to work may be up to 4-8 weeks. There will probably be some pain after the procedure and is usually localized to the incision site. However, just because there is less or no pain, always consult your physician before beginning any physical work.
At home, you will need to continue to rest. You will be instructed on how to gradually increase your activity. You may still need to take the pain medications for a while. However, pain and discomfort should begin to reduce within a couple of days after surgery. The doctor will discuss with you other techniques for reducing pain and increasing flexibility before you leave for home. The doctor will also discuss with you a time frame for when you can resume basic activities such as walking, driving and light lifting, and when you can return to more advanced activities such as physical labor, sports and yard work.