Failed Back surgery syndrome

Failed back surgery syndrome affects up to 40 percent of patients who undergo traditional open back surgery

The incidence of FBSS depends upon many factors and occurs less in the cervical region (neck) than the lumbar region (lower back) of the spine. The risk of developing FBSS is much lower after discectomy than following open spinal fusion. After review of the studies published by the U.S. National Institutes of Health, the only scientifically defendable statement that can be made about the incidence of failed back surgery syndrome is that the less invasive the spinal surgery, the less likely that FBSS will result. To date, the least invasive spine surgery is minimally invasive spine surgery, such as the procedures performed at Laser Spine Institute to treat degenerative spine conditions.

What is FBSS?

FBSS is not actually a syndrome but a generalized term used to describe the condition of patients who have not had successful results with spine surgery to treat neck or back pain. Specifically, the term applies when spine surgery has not alleviated the problem or has created even greater problems, and when patients experience continuous pain after surgery.

Primary causes

Many factors can contribute to FBSS, including:

• Failure to adequately diagnose the condition(s)

• Failure to adequately treat the condition(s)

• Spinal fusion failure

• Surgery performed at the wrong level of the spine

• Creation of new spine conditions at another level after open-spine surgery (very common)

• Scar tissue formation

• Hardware insertion

• Missed fragment of disc or bone still pinching nerve

• Inadequate decompression of nerve root

• Nerve damage

Symptoms

Patients with FBSS may experience or develop:

• Continued/chronic pain

• New spine conditions

• Pain above or below the treated level of the spine

• Limited mobility

• Inability to recuperate

• Dull/aching pain in neck, back or legs

• Sharp/stabbing pain in extremities

• Joint immobility

• Spasms

• Anxiety

• Depression

• Dependence on prescription drugs                                                                                                                                   

The role of minimally invasive procedures in management of FBSS

The FBSS is a complicated condition and so many minimally invasive procedures will be performed in it's management according to the clincal examination in correlation with MRI findings, for examples:

Radiofrequency on medial branches which supply facet joints in case of facet joints arthropathy
 
  

Pulsed radiofrequency on dorsal horn ganglions for the affected nerve roots according to dermatomal distribution
 
  

Adhesolysis of the stenotic spinal canal using caudal RACZ catheter or NAVI catheter

Biacuplasty for the pain generated from the prolapsed discs

 

Spinal cord stimulation for the resistant failed back syndrome