Three Potential Causes of Failed Back Surgery Syndrome

If a patient suffers from continued back or leg pain after laminectomy or discectomy surgery, he or she may have what is referred to as “failed back surgery syndrome.” About 200,000 lumbar laminectomy and discectomy (microdiscectomy) surgeries are performed every year in the United States. Approximately 90% of these surgeries will result in a good outcome, meaning the patient’s pain is eliminated or significantly reduced. The remaining 10% of patients who do not do well after spine surgery will embark upon a mission to find the source of their continued back or leg pain.

Often, a comprehensive physical examination and appropriate diagnostic imaging techniques can pinpoint the underlying cause of a patient’s pain. For example, a doctor may be able to provide a definitive diagnosis of recurrent disc herniation or another disorder, which is causing the continued pain. Three causes of pain after failed back surgery are outlined below:

1. The first potential cause is improper preoperative patient selection before back surgery, which is the number one cause of failed back surgery syndrome. To diagnose this condition, surgeons look for an anatomic lesion in the spine that they can correlate with a patient’s pain pattern. However, some lesions make a more accurate diagnosis than others since other sources of pain can mimic back pathology (such as sacroiliac joint dysfunction, hip pathology, and others).

2. Another potential cause of pain is recurrent disc herniation after spine surgery, which usually occurs after a discectomy/microdiscectomy spine surgery. In this scenario, a patient typically experiences substantial pain relief after surgery, followed by a sudden recurrence of leg pain. These symptoms tend to appear acutely, and an MRI scan can help to diagnose this condition.

3. Finally, spine surgeons must consider technical error during surgery as a cause of post-surgical pain. For example, a fragment of herniated disc material may have been missed. Or, a piece of bone may have been left adjacent to the nerve. Both of these situations result in a compression of the nerve root that can cause significant pain. Postoperative imaging and clinical presentation will help your spinal surgeon determine the exact cause of pain.

Dr. Sharma works with patients who are suffering from the pain of a failed back surgery. Please make an appointment to discuss your options today.