Failed back and neck surgeries can create a condition called FBSS. So, what is failed back syndrome? This condition occurs when a patient has not had a successful result from the surgery and continues to experience continued or increased pain. It's a complex and multifaceted condition that can be physically and emotionally draining.

FBSS pain affects a diverse demographic. It is not limited to any specific age group, gender, or ethnicity but is more prevalent among those who have undergone spinal surgeries. Many factors contribute to unsuccessful surgery, such as smoking, uncontrolled diabetes, poorly performed surgery, or non-adherence to post-surgical instructions. But each patient is different, and each surgery is unique. At Pain and Spine Specialists, we can help establish the basis for continued pain and help you determine the best route forward.

The parts of the body affected by FBSS are primarily the back and neck, where the original surgery was performed. However, the syndrome can also cause pain in the extremities, particularly the legs. The pain can vary from mild discomfort to severe, debilitating agony.

FBSS can occur due to a variety of reasons, but the most common causes of this condition include:

-Recurrent Herniated Disc: Even after surgery, disc herniation can reoccur at the same spot, causing similar symptoms as before.
-Scar Tissue Formation: The formation of scar tissue around the surgical area following a spine procedure. This scar tissue can compress the nerves, leading to pain.
-Hardware Fracture: In some cases, the hardware used during spine surgery, like screws or plates, may break or move from its original position, causing discomfort and pain.
-Inadequate Surgical Procedure: If the initial surgical procedure did not address the root cause of the pain or if the surgery was not performed correctly, FBSS could result.
-Development of Post-Surgery Diseases: In some cases, patients may develop additional diseases in the post-surgery period. This could aggravate existing problems and cause FBSS.
-Nerve Compression and Inflammation: Nerve compression and inflammation can occur due to the scarring and adhesion of tissue around the area of surgery.

There are multiple types of back and neck surgery. For example, adjacent segment disease is a spinal disorder that can result after spinal fusion. While it can develop due to the natural degeneration of the spine with aging, it is mainly known as a complication of spinal fusion, which is also performed more as people age. If the spinal fusion was in the lumbar spine or lower back, that person may feel:

-Lower back pain
-Pain that radiates from the lower back into one or both legs or feet
-Neurological symptoms such as tingling, numbness, or weakness
-Pain while walking or difficulty getting up

Artificial disc replacement surgery can often be the course of treatment for severe disc herniation. Herniated discs alone do not usually cause pain, but they can cause compressed nerves when they bulge and press against the nerve. This bulging can lead to chronic pain, and an artificial disc is meant to correct this problem, but it can fail for several reasons. The artificial disc may cause a bone fracture to an already weak spine, or it may not have been made correctly or be the best fit for your spine, or it can make the bone in the spine erode and result in a misalignment with the vertebrae.

A laminectomy is meant to relieve pressure on the spinal cord or nerves. During the procedure, the surgeon will make an incision on the back of the neck to remove a piece of bone on the back of the vertebrae, known as the lamina. While this can create more space in the spine to relieve that pressure, it can also make the spine less stable or possibly injure the nerves.

Also, spinal fusions are one of the most common surgeries for back and neck pain relief. During a spinal fusion, a surgeon removes the spinal disc between two or more vertebrae, then fuses the vertebrae with bone grafts or metal devices with screws to create a single, stable piece of bone.

What can be done for failed back surgery? Methods we use at Pain and Spine Specialists include injection therapies. Injection therapies can provide immediate relief from pain and inflammation. Specifically for FBSS, we often use epidural steroid injections, facet joint injections, and sacroiliac joint injections.
These injections can help reduce inflammation around the nerves and joints in your spine, relieving pain.

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