Failed Back Surgery Syndrome
Failed back surgery syndrome occurs when patients continue to experience pain or develop new symptoms after spine surgery. While challenging, many cases can be successfully treated with advanced revision techniques.
Symptoms of Failed Back Surgery Syndrome
- Continued pain - Persistent pain at the original surgery site
- New symptoms - Pain in different areas than before surgery
- Reduced function - Inability to perform activities as expected
- Scar tissue pain - Burning or aching around the incision
- Nerve symptoms - Numbness, tingling, or weakness
- Hardware discomfort - Pain related to screws or implants
- Adjacent level problems - New pain above or below fusion
- Psychological impact - Frustration and depression from ongoing pain
Causes of Failed Back Surgery Syndrome
Incomplete Decompression
Insufficient removal of bone or disc material, leaving nerves still compressed.
Scar Tissue Formation
Epidural fibrosis that can compress nerves and cause pain around the surgical site.
Hardware Problems
Loose screws, broken rods, or hardware malposition causing pain or instability.
Adjacent Segment Disease
Accelerated degeneration of levels above or below a fusion due to increased stress.
Incorrect Diagnosis
Surgery performed for the wrong condition or at the wrong level.
Recurrent Disc Herniation
New disc herniation at the same or different level after discectomy.
Diagnosis
Comprehensive Evaluation
Dr. Greenberg conducts a thorough review of your surgical history, current symptoms, and previous imaging. Understanding what was done previously is crucial for planning effective treatment.
Advanced Imaging
- MRI with contrast: Distinguishes scar tissue from recurrent disc herniation
- CT scan: Evaluates bone healing and hardware position
- Specialized tests: Nerve studies or diagnostic injections when indicated
Why Greenberg Spine
Dr. Greenberg's fellowship training at Mayo • Hopkins • Brown provides expertise in complex revision surgery using advanced endoscopic and minimally invasive techniques.
- Comprehensive revision surgery experience
- Endoscopic scar tissue removal
- Minimally invasive revision techniques
Conservative Treatment
Pain Management
Comprehensive pain management including medications, injections, and nerve blocks to control symptoms.
Physical Therapy
Specialized rehabilitation to improve function and reduce pain while working around surgical limitations.
Psychological Support
Counseling and support to address the emotional impact of ongoing pain and failed expectations.
When to Consider Revision Surgery
Objective Surgical Criteria
Revision surgery is considered when there's a clear anatomical problem that can be corrected and conservative treatment has failed.
Clinical Indications
- Identifiable anatomical problem
- Hardware failure or malposition
- Recurrent disc herniation
- Adjacent segment disease
Revision Goals
- Address specific anatomical problem
- Remove scar tissue when appropriate
- Correct hardware problems
- Improve function and quality of life
Recovery Expectations
Recovery Timeline
First 2-4 Weeks
Initial healing, pain management, and gradual mobilization with restrictions.
6-12 Weeks
Physical therapy begins, gradual return to light activities, continued healing.
3-6 Months
Significant improvement expected, return to most normal activities.
6-12 Months
Maximum improvement achieved, return to full activities when appropriate.
What to Expect
Realistic Expectations
Revision surgery success depends on the specific problem and patient factors.
Gradual Improvement
Recovery may be slower than primary surgery but can achieve significant improvement.
Comprehensive Care
Multidisciplinary approach including pain management and rehabilitation.
Frequently Asked Questions
What causes failed back surgery syndrome?
Failed back surgery syndrome can be caused by incomplete decompression, scar tissue formation, hardware problems, adjacent segment disease, or incorrect initial diagnosis.
How is failed back surgery syndrome diagnosed?
Diagnosis involves detailed history, physical examination, advanced imaging (MRI, CT), and sometimes specialized tests to identify the specific cause of persistent symptoms.
What are the treatment options for failed back surgery?
Treatment options include pain management, physical therapy, revision surgery, endoscopic procedures, and advanced techniques to address scar tissue and hardware issues.
When is revision surgery recommended?
Revision surgery is considered when there's a clear anatomical problem that can be corrected, such as incomplete decompression, hardware failure, or adjacent segment disease.
What is the success rate of revision spine surgery?
Success rates vary depending on the specific problem and patient factors, but careful patient selection and advanced techniques can achieve good outcomes in appropriate candidates.
Related Conditions
Experiencing Failed Back Surgery? Schedule a consultation with Dr. Marc Greenberg.
Get expert evaluation and learn about advanced revision treatment options.
This information is for educational purposes only and should not replace professional medical advice. Individual results may vary. Consult with Dr. Greenberg to determine the most appropriate treatment for your specific condition.