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Failed Back Surgery

Many patients suffering from chronic back pain look to surgery as a way to relieve their pain. While there are some situations when surgery is necessary, more often it is not the best way to resolve back problems. Among the many risks associated with back surgery, perhaps the greatest is not knowing whether it will successfully eliminate your pain.

Back Surgery Types

There are many different types of back surgery depending on the type of injury or damage that you have. While some surgeries have higher predictive success rates, none of them provide a guarantee that your pain will be alleviated. Here is a brief overview of the most common types of back surgery:

  • A spinal fusion is the most common option when there is non-specific, chronic pain. This surgery involves connecting two or more vertebrae together to eliminate motion between them. This can eliminate painful motion between vertebrae and provide stability to the spine.
  • A diskectomy is a procedure to remove damaged parts of a herniated disk, which can irritate or compress nearby nerves. This procedure is more helpful for treating pain that radiates down the arms and legs and less helpful in treating back and neck pain.
  • A laminectomy removes part of the lamina, the back part of a vertebra covering the spinal canal. This enlarges the spinal canal to relieve pressure on the spinal cord or nerves.
  • A foraminotomy reopens the foramen in order to relieve pain from compressed nerves. The foramen is a gap in the spinal canal where nerves enter and exit. This procedure reopens that space when it has become narrowed by overgrowth or bone.

Back Surgery Recovery

The recovery process after back surgery varies based on the type of surgery, the overall health of the patient and the symptoms present at the time of surgery. While this process is unique to each person, there are a few things that all patients can expect after back surgery including regular physical therapy, special instructions for sitting and sleeping, narcotics to help manage the pain, wound care for the incision and limitations on movement and lifting.  Most people are able to return to work and normal life activities around 2-3 months after back surgery.

When Back Surgery Goes Wrong

It’s important to understand that back surgery changes your anatomy and does not always target your pain. As a result, some patients continue to feel pain – and in some cases feel increased pain – following back surgery. This condition is referred to as Failed Back Surgery Syndrome (FBSS), but that’s actually a misnomer. FBSS isn’t a syndrome, but rather is a generalized term that is applied to patients that have not gotten a successful result from back surgery and that continue to experience pain after surgery.

This type of syndrome is unique to back surgery – there is no equivalent for say, knee or cardiac surgeries – and even under the best conditions back surgery only has a 45% predictive success rate. There are many reasons why this is the case, but understanding a little more about back surgeries can help explain this low success rate and why FBSS is as prevalent as it is.

Without going into the specifics of various surgeries, you can nevertheless boil back surgery down to accomplishing two things: it can decompress a pinched nerve joint and it can stabilize a painful joint. While we wish it could, back surgery cannot literally cut out a patient’s pain. Instead, it can only change a patient’s anatomy and, thus, is only effective when pain is caused by an anatomical abnormality.

What this means for patients is that it’s important to identify an anatomical injury before back surgery as opposed to undertaking surgery in hopes of identifying an abnormality during the process and alleviating generalized pain. It’s no surprise, based on this information, that the primary reason for FBSS is that the abnormality or lesion operated on was not what was actually causing the patient’s pain.

Alleviating Pain after a Failed Back Surgery

If you are continuing to experience pain following back surgery, you do not have to live with that pain. Even after a failed surgery, there are many treatments available to you including physical therapy, nerve blocks, nerve stimulation, medications and spinal cord therapy. Rather than allowing this pain to linger, contact a pain management physician to begin a treatment plan as soon as possible.

If you are considering back surgery, we highly recommend that you first call us so we can do a comprehensive physical exam and, when appropriate, recommend alternative therapies. Additionally, if you have had a failed back surgery, call us as soon as possible and let our pain management specialists create a comprehensive care plan for you so that we can get you back to a normal, pain-free life as soon as possible.

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