Understanding Failed Back Surgery Syndrome

As frustrating a condition as they come, failed back surgery syndrome plagues thousands of people after surgery complications every year. With that in mind, Premier Pain is taking patients on a closer look at the condition and its common causes.


What is Failed Back Syndrome?

Failed back surgery syndrome (or failed back syndrome), also referred to as post laminectomy syndrome, is a multidimensional pain condition through which pain remains despite corrective surgery being performed.

What Causes Failed Back Syndrome?

One of the most frustrating factors of Failed Back Syndrome is that its causes have thus far been deemed multifaceted. FBS sufferers have undergone surgery for pain focused in the lumbar region of the back and spine. However, the cause of FBS has been theorized to plausibly be as psychological in some cases as it is medical.

The most common symptoms of Failed Back Syndrome are a dull or aching back pain, pain that radiates through the hips, buttocks or thighs, or more severe, stabbing pain in the back or legs.

The common causes of Failed Back Surgery Syndrome are listed below.

Herniated Disc Surgery

In the case of patients with a herniated disc, removal of said disc can lead to another disc herniation later. A herniated disc isn’t completely removed, but instead leaves at least 30-40% of it intact. Not only can reduced disc size cause other herniation, it also is still possible for the remaining disc itself to slip.

Posterior laminectomies for herniation also cause potentially significant damage themselves to major structures in the abdominal area and pelvis. A common part of the body at risk is the left iliac vein, which lies near the discs within the back. If an iliac vein is cut, persistent, recurring pain can be nearly as crippling as the herniation itself. While a second surgery done soon after the initial operation can solve those issues, it’s not always the case.

Spinal Stenosis

Spinal stenosis is an abnormal narrowing of the spinal canal and can occur within any region of the spine. When this narrowing occurs, the restriction of the spinal canal can cause weakness, numbness, or pain. When it occurs in the lumbar vertebrae, it is referred to as lumbar stenosis.

Lumbar stenosis is commonly associated with degeneration due to aging, but it also can be caused by tumors, spinal disc herniation or surgery for the herniation itself. In some cases, the stenosis has been overlooked due to the herniated discs. Since it hasn’t been addressed, the pain remains.

Spinal Fusion Surgery Complications

Spinal Fusion is considered a viable option for a variety of medical conditions, including fractured vertebrae, scoliosis, herniated discs, degenerative disc disease and spinal tumors. There are multiple techniques, but in the lumbar region of the spine, the posterolateral fusion and interbody fusion techniques are used. In the former, a bone graft is placed between the lateral processes of the vertebrae, which are then affixed with screws or wire with metal rods connected for stabilization. With interbody fusion, the entire intervertebral disc between vertebrae is replaced with a bone graft. Spine alignment is maintained with a plastic or titanium support.

Spinal fusion has become increasingly popular in the United States. According to the New York Times, the reimbursements by Medicare and private insurers for the  fusion hardware alone was $2.5 billion in 2003. Unfortunately, there have been postoperative complications for some patients, with many reporting sacroiliac joint degeneration due to the fusion.

Unfortunately, the greatest challenge for doctors here is to locate the source of a patient’s pain. Surgical solutions require a specific anatomy operation. If there is no specified structure, the pain cannot be relieved.

Other Causes of Failed Back Syndrome

There are several other potential causes of failed back syndrome, including epidural scarring following a laminectomy, postoperative infection or nerve injuries.

For those who still smoke, quitting is highly advisable prior to spinal surgery. Since the late 1970s, several studies have shown cigarette smokers have had significantly higher failure rates. This is believed to be due to nicotine interfering with bone metabolism and potential blood vessel restriction. Fortunately, quitting after surgery also has been shown to help.

Treating Failed Back Syndrome in New Jersey

There are only a handful of options for patients managing FBS pain in New Jersey. For years, far too many physicians relied on opioids for their patients’ pain management. Unfortunately, this has led to addiction and abuse of painkillers, in addition to long-term side effects associated with opioids. A more controversial surgical option is lumbar total disk replacement, but it has been met with mixed success rates.

One of the most effective treatments that Premier Pain Centers has found to be consistently effective is electrical stimulation. Since it uses electrical impulses to block the pain receptors of the affected area, these stimulators have the benefit of reducing pain without the chemistry-altering side effects of narcotics. If you are chronically suffering from Failed Back Syndrome or another neurological pain disorder, contact us today at (732) 380-0200.