Failed back syndrome (FBSS, or failed back surgery syndrome) is a generalized term that is which describes patients who have not had a successful result with back surgery or spine surgery and who continue to experience pain after surgery. Back surgery can be life changing but even with optimal conditions will only be successful about 95% of the time. Since pain cannot be seen, there can be no guarantee that surgery will eliminate the pain. Selection of the correct procedure is also paramount to get the best result from back surgery.
Symptoms of failed back syndrome are the same as the symptoms the patient had surgery for in the first place. Pain is the most common symptom which can be chronic, debilitating, sharp or dull. Regardless of the cause, the most common symptoms include neck or back pain and stiffness, numbness or tingling in the arms and neck and legs, weakness of the arms and legs, a burning sensation in the arms and legs, trouble with walking or difficulty with hand coordination.
Any surgery that does not control your symptoms of pain can be considered failed back surgery. Spinal surgery can only stabilize a painful back joint or decompress a nerve root or the spinal cord. Surgery cannot always remove pain. Back surgery can change back anatomy and correct the spine in the most likely area of back pain, but even a successful surgery can leave a patient with pain. Correct diagnosis as well as an appropriate surgery can prevent failed back syndrome in most but not all cases. The most common cause of failed back surgery is not operating on the problem causing the pain.
Diagnosis of failed back syndrome includes back pain after back surgery. This involves a combination of the patient’s history, examination and testing which may include:
A Myelogram uses a special dye injected into the spinal fluid and an X-ray or CT scan to better look at the spinal cord. EMG or electromyography tests the health of muscles and the nerves that serve them.
Proper diagnosis is paramount with both primary back surgery as well as the secondary back surgery of failed back syndrome. Your care will depend on the severity and causes of your symptoms. Conservative treatments include nonsteroidal anti-inflammatory drugs (NSAIDs) to decrease pain and swelling, and steroid injections that reduce swelling. Heat or cold like an ice bag, heating pad, or hot shower can help reduce pain. Physical therapy can involve muscle strengthening exercises or training in how to control your cervical spine more safely. A cervical collar or back brace might be used to support your spinal cord while limiting movement.
An additional surgery may be indicated where there is chronic and severe pain that is not relieved by conservative treatment. Surgical treatments may include removing bone spurs or portions of the cervical spine to widen the space between vertebrae. Surgery will also relieve pain much more rapidly than rest and medication. Connecting some of the vertebrae together can stabilize an area of the spine using metal rods and bone grafts. Surgeries include one or a combination of the following procedures:
The best way to manage your failed back syndrome is to educate yourself as much as you can regarding your condition, and to become involved in your own care and treatment with your healthcare providers. Keeping your back as healthy as possible includes having a healthy weight, good posture, proper lifting techniques, and regular exercise.
The neurosurgeons of Norelle Health are highly trained and skilled in the diagnosis, management, and treatment of failed back syndrome. Our neurosurgeons can provide the optimal treatment. Neurosurgery is considered essential by insurances and should be covered with your plan. As out-of-network providers, we will check your benefits for you and let you know what they are so there are no surprises. We use an individualized treatment plan for your concerns to provide a personalized holistic plan of care. If you would like assistance, please feel free to contact us (link to contact page) or call our office (link to phone number).