Failed Back Syndrome

Post-Surgical Chronic Pain

In some cases, patients who undergo traditional “open” spine surgery may not improve with healing—or may develop worsening pain symptoms. Sometimes diagnosed as failed back surgery syndrome (FBSS), this complex problem occurs in up to 40 percent of spine surgery patients. When left untreated, FBSS can lead to severe chronic pain and other disabling, long-term symptoms.

Causes of Failed Back Surgery Syndrome

Spine surgery is generally used to stabilize the spine or relieve nerve pressure, but in some cases, symptoms continue. Symptoms can vary depending on the original issue that surgery was done to address.

Possible causes of FBSS include, but are not limited to:

• Improper pre-operative diagnosis & recommended treatment
• Surgery performed at the wrong level of the spine
• Technical surgical errors
• Failed spinal fusion
• Fused bone that impinges on adjacent nerves
• Arachnoiditis (inflammation of the arachnoid membrane that surrounds the spinal cord)
• Epidural fibrosis (scar tissue that forms around the nerve root)
• Neuropathic pain syndromes
• Recurrent disc herniation
• Spinal stenosis
• Pain caused by screws, plates, or hardware implants

Because chronic pain can have life-altering consequences, untreated FBSS may also lead to pain-related depression, anxiety, PTSD, and other behavioral health conditions over the long term.

Diagnosis of Failed Back Surgery Syndrome

FBSS is considered a diagnosis of exclusion, and its identification relies primarily on patient reports of previous surgeries/interventions, along with an in-depth discussion of what has not worked. The doctors at Princeton Brain, Spine & Sports Medicine take time to understand your pain, surgical history, and symptoms. To rule out surgically correctible conditions, they may also use diagnostic tools like CT scans, MRI scans, bone scans, discography, and diagnostic injections (if nerve root involvement is indicated).

Treatment for Failed Back Surgery Syndrome

Spine surgery is a major decision, and it can be devastating when a procedure does not offer pain relief or leads to additional symptoms. FBSS occurs more often in the lumbar than in the cervical spine, and the likelihood of the condition is higher with open spine surgery procedures than it is with minimally invasive surgery.

Currently, there is no “cure” for FBSS other than procedures that treat the underlying or improperly treated lumbar or cervical spine condition. Conservative FBSS treatment methods include physical therapy, heat or ice, and prescribed pain medications. Your Princeton Brain, Spine & Sports Medicine neurosurgeon may also recommend a minimally invasive procedure if the original cause of your pain has not been properly addressed.

When treating FBSS, neurosurgeons at Princeton Brain, Spine & Sports Medicine recommend therapies and treatment approaches best suited to the structural cause of pain as well as a patient’s pain level, disability, and overall health.

Intervention options  vary, and may include:

• Surgical decompression
• Spinal fusion
• Spinal cord stimulation (SCS)
• Referrals to pain intervention specialists

FBSS Specialists in New Jersey blending compassionate care with the latest advances in non-surgical and minimally invasive pain relief, the neurosurgeons at Princeton Brain, Spine & Sports Medicine proudly serve patients at seven NJ & PA locations. To schedule a back pain consultation or request a second opinion for FBSS, call 609.921.9001 in New Jersey or 215.741.3141 in Pennsylvania. For your convenience, you can also submit a confidential online inquiry, and a patient advocate will be in touch to answer your questions.