Failed Back Surgery Syndrome

What is Failed Back Surgery Syndrome?

Failed back surgery syndrome (also known as FBSS, or failed back syndrome) is actually not a syndrome at all. It is a broad term that is often used to describe the condition of patients who have had an unsuccessful result with back surgery or spine surgery, and have experienced continued pain after surgery.

There are a variety of reasons why a back surgery may or may not work. It is important to note that even with the best surgeon and the best indications, spine surgery is no more than 95% predictive of a successful result.

What are the Causes?

Spine surgery generally accomplishes only two things:

  • Decompress a nerve root that is pinched.
  • Stabilize a painful joint.

Unfortunately, back surgery or spine surgery cannot literally remove the source of a patient’s pain, and is only able to change anatomy. An anatomical lesion (injury) that is a probable cause of back pain must be identified prior to rather than after back surgery or spine surgery.

By far the number one reason back surgeries are not effective and some patients experience continued pain after surgery is because the cause of the pain was not accurately identified; for example, the lesion that was operated on is not in fact the cause of the patient’s pain.

What are the Symptoms?

The most obvious symptom of failed back surgery syndrome is persistent, chronic pain that is not associated with the healing process. Other symptoms associated with FBSS include:

  • New pain at a level different from the location treated
  • Inability to recuperate
  • Restricted mobility
  • Sharp, stabbing back pain
  • Numbness or pain radiating through the lower back into the legs
  • Back spasms
  • Anxiety, depression and sleeplessness
  • Potential dependence on pain medication

What are the Treatments?

Treatment for failed back surgery syndrome may include:

  • Physical therapy
  • Nerve blocks
  • Medications
  • Injections
  • Chronic pain management program

Typically, correctable structural problems are investigated and, if identified, surgery may be performed to address these issues with Failed Back Syndrome. This may include facet joint or sacroiliac joint rhizotomy. Sometimes no correctable cause of the patient’s symptoms with Failed Back Syndrome is identified. In these cases, spinal cord stimulation (SCS) or narcotic pumps may be used for pain control. It is important to discuss treatment options with the pain management specialists at Comprehensive Pain Physicians in deciding which treatment, if any, may be best for you.