FAQs on Failed Back Surgery Syndrome in Phoenix and Scottsdale AZ
Many patients with back problems undergo spinal surgery. When surgery of the spine fails to eliminate pain, or brings on a new type of pain, the condition is called failed back surgery syndrome (FBSS).
How common is FBSS?
Nearly 600,000 people undergo back surgery each year in the U.S., and many of these individuals continue to have pain after the procedure. For many people who undergo surgery of the spine, 50% or more of the pain will remain.
What is the purpose of spinal surgery?
Spine surgery is designed to stabilize a painful joint, decompress a pinched nerve root, provide pain relief, and fix an abnormal curvature. Many people have back surgery.
What causes failed back surgery syndrome?
There are many reasons why surgery of the back fails. It may be related to a judgment error, such as an MRI scan misinterpretation, or it can be related to injury during surgery. Scar tissue forms along the spine in the surgical area, causing much pain. In order to find the cause of FBSS, the doctor will order new testing and procedures. The leading cause of FBSS is residual foramenal stenosis. Another primary cause is that the procedure effectively removed a herniated disc or lesion, but did not eliminate the pain. Painful discs, recurrent disc herniation, and nerve damage also can cause this syndrome.
How is FBSS diagnosed?
Doctors diagnose FBSS based on symptoms and a medical history. After conducting a physical examination, the doctor will also do some diagnostic testing. In a large study, researchers found that diagnostic injections and x-rays improved that patient’s ability to find the cause of back pain in patients with FBSS.
What is the treatment of FBSS?
The treatment of failed back surgery syndrome depends on the severity of the symptoms and extent of the problem. Options include:
Medication – For severe neuropathic pain, neurogenic agents are used, such as Neurontin or Lyrica. In addition, analgesics are prescribed.
Physical therapy – To alleviate pain, a physical therapist often uses ultrasound, heat/cold therapy, electrical stimulation, and massage. Physical therapy exercises are used to increase flexibility and improve strength.
Facet joint injection (FJIs) – Given in a series of three, these injections involve small needles inserted into the face joints along the spine. A long-acting anesthetic is instilled near the nerves of the facet joint. In a clinical study, FCIs were found to offer both short-and long-term pain relief.
Epidural steroid injection (ESI) – With this procedure, the pain specialist injects a corticosteroid agent into the epidural space, which is right outside the spinal cord. Research shows a success rate of 80-90% with this procedure.
Transcutaneous electrical nerve stimulation (TENS) – This procedure uses electrodes positioned on the skin along the spine. The unit delivers tiny electrical impulses that provide pain relief. Studies show that TENS has a 70-95% success rate for chronic pain relief.
Spinal cord stimulation (SCS) – A spinal cord stimulator is used for patients who have failed on other treatments. With this procedure, the doctor surgically implants a tiny device in the subcutaneous tissue, which has small electrodes that attach to the spinal cord region. Studies show that SCS provides long-term pain relief for patients with FBSS.