Salvaging Failed Back Surgery

Low back pain is one of the most common ailments affecting the general population. Among individuals with labor intensive work, the prevalence of low back pain is alarmingly high. Even though conservative management is very effective in treating such pain, some cases of low back pain are resistant to all forms of such treatments. When the pain gets excruciating and unbearable for a considerable period, surgery may be one of the treatment options offered to patients.

For the right indications and in selected cases, surgery may offer hope for patients suffering from debilitating back pain. In some cases, however, surgery fails to achieve its intended effect and leaves the patient without significant relief and in some cases even worse off than before. As the number of spinal surgeries being done in the US increases, the number of these failed procedures is also on the rise. This condition has been called Failed Back Surgery Syndrome (FBSS).

Patients suffering from FBSS face significant challenges. They may not get diagnosed with this problem right away and there may be more procedures performed on them that may worsen the situation. It is not uncommon for these patients to have undergone several back operations without significant benefit. It is frequently associated with dependence on long term pain medicine, significant disruption of day to day work and leisure activity and breakdown of social life.

Until very recently, this problem was not fully recognized, much less addressed in a timely manner. Most spine specialists were unaware of existence of this condition and therefore were unable to offer meaningful solution to this problem. Recent advancements in our understanding of spine has helped the spine community tremendously in recognizing and treating this problem at an early stage.

Treatment for FBSS begins with a consultation with a spine specialist who has a special interest and expertise in this problem. Frequently a new set of imaging studies may be ordered to assess the status of spine and the implanted surgical hardware. After a careful history, physical exam and review of up to date imaging studies, the specialist will formulate a plan that would typically involve multiple disciplines. This may include a combination of physical therapy, epidural injections or corrective surgery to address any obvious problems with earlier procedures. A technique that is increasingly being used to treat FBSS is spinal cord stimulation. This can sometimes provide almost immediate pain relief to patients suffering from FBSS.

Failed back surgery syndrome is a complex problem with no easy answers. Patients who suspect that they may be suffering from it need to contact an appropriate Spine Specialist who understands the complexity of modern spinal treatments.

By , MD, FAANS, NC and FH
Dr. Sharma founded Virginia Spine Specialists, the leading spine care center in Northern Virginia with offices in Manassas and Fredericksburg. He specializes in minimally invasive solutions to problems of the entire spine. For an appointment with Dr. Sharma, call toll free 1-855-SPINE-FIX (1-855-774-6334).