What to Expect from Revision Spine Surgery
Deciding to undergo spine surgery isn’t easy. You’ve probably dealt with pain and other difficult symptoms for a long time. You’ve felt frustrated when conservative treatments didn’t seem to help. You weighed the risks and rewards of spine surgery and finally chose to go through with it. Not every spine surgery is successful, however. In some cases, revision spine surgery may be necessary to address complications.
Just the thought of revision spine surgery can send you to a dark place. You put your faith in a surgeon’s care only to find that your symptoms remained or even worsened—a condition known as failed back surgery syndrome (FBSS). And, now you’re challenged with the thought of undergoing another surgery because the first one didn’t work.
It’s disheartening. Exhausting. You just want relief. Will another surgery actually help?
For some, revision spine surgery may correct issues caused by failed back surgery or other spine procedures.
Let’s take a look at why some spine surgeries fail and how revision spine surgery can help.
Why Do Some Spine Surgeries Fail?
Operating on the spine is complex. Even the best surgeons using the latest technology don’t have a 100% success rate. Mistakes happen. Errors in judgment and inappropriate procedures may not produce the desired outcomes.
Part of this can be due to the surgeon’s error, but there are many other factors that come into play.
Some patients may choose back surgery—either knowingly or otherwise—even if it was never indicated to be a therapeutic option. This can be due to misdiagnosis, misinformation, or simply the patient putting too much faith in a procedure that may not actually work for his or her condition.
There’s more: A person’s behaviors and other medical conditions can contribute to a failed surgery.
For example, smokers have a higher risk of failed spine surgeries. Why is this? As you probably know, cigarette smoke is filled with toxic chemicals. Nicotine, for example, affects the body’s ability to heal bones. If a person undergoes a spinal fusion surgery and continues to smoke, the bones may not fuse properly.
Of course, smoking isn’t the only reason for failed spinal surgeries. In fact, those with autoimmune disorders, peripheral artery disease, obesity, and diabetes may also have a higher risk of developing complications after surgery. In addition, a person’s psychosocial well-being also has a significant effect on treatment outcomes.
Causes of Failed Spine Surgery
So what causes these surgeries to fail? There are many factors. Some causes actually feed off each other making them even more difficult to pinpoint. We already mentioned some common issues above. Here are more reasons why individuals still experience pain and other symptoms after spinal surgery:
- A surgical error that causes damage at the site of the procedure
- Scar tissue that forms in or around the spine
- The spine fails to grow together after a spinal fusion surgery
- Hardware or spinal implant failures
- Adjacent segment disease: when parts of the spine near the spinal fusion site take on extra stress and experience accelerated wear and tear
- Surgery performed at the wrong area of the spine
- An intervertebral disc becomes herniated again
- Incorrect diagnosis
- General complications of surgery such as infection
Your Spine Surgery Failed: Now What?
Nobody wants to hear that their surgery failed. Undergoing the stress and hardships of another surgery may seem like more than you can handle. Luckily, unless you experience severe symptoms (mentioned below), doctors often suggest conservative treatments before opting for spinal revision surgery.
Wait a minute. This seems pretty confusing.
After all, you needed surgery before. Why go back to conservative treatments that didn’t seem to help in the first place? Is it just a waste of time?
As you know, surgery carries risks. Those suffering from failed back surgery are less likely to experience favorable outcomes with more surgery. That’s not to say you may not benefit from a spinal revision surgery—but it may be used as a last resort.
Most conservative treatments, after all, tend to have fewer risks and adverse effects. Depending on the cause of your failed surgery, you may be able to achieve relief with conservative treatments.
What You Need Before Starting Conservative Treatments
Want to know how to deal with and even prevent failed back surgery? Make sure your diagnosis is correct. Find a spine surgeon whom you can trust—often one who collaborates with other disciplines so that you have a full arsenal of treatment options available.
Spine conditions can be tricky to diagnose. After all, many conditions share common symptoms. Obtaining an accurate diagnosis is crucial to the success of your spine surgery. If you’re suffering from a failed spinal surgery, make sure you find an orthopedic doctor who specializes in treating this condition. The added experience can go a long way in treating your pain and other hardships.
Make sure the diagnostic process includes:
- A thorough physical examination
- An accurate and detailed pain history
- An assessment of any other factors that may impact the success of a surgery (other medical conditions, mental health concerns, etc.)
- Using the latest diagnostic imaging tools
What kind of diagnostic imaging can you expect and why?
- X-rays ensure that the bones are aligned properly and all hardware is staying in place.
- Computed tomography (CT) scans use a series of x-ray images taken from different angles to obtain a more detailed look at cross-sectional images of the bones and other soft tissues.
- Magnetic resonance imaging (MRI)scans use magnet and radio waves to look at structures in the body. This can be helpful in finding any nerve compression or issues with discs. MRIs are often the most effective imaging tool to determine issues after the initial surgery.
- Bone scans can determine the presence of bone infections after spinal surgery.
- Electromyography (EMG) is a diagnostic procedure that takes a look at the health of nearby muscles and the nerve cells that control them. EMG tests can reveal any nerve dysfunction that exists due to your spinal issues.
Common Conservative Approaches After a Failed Spinal Surgery
No single conservative approach is the “magic bullet” for issues that appear after spinal surgery. In fact, using an interdisciplinary approach may help best with this complex condition. Typically, a team addresses several aspects of your symptoms and recovery. These may include:
- Pain management: Over-the-counter pain medications like ibuprofen or acetaminophen may be the first line of defense for treating pain. Sometimes, however, prescription medications may be necessary. Stronger medications such as opioids should only be used exactly as prescribed for short-term pain relief. Doing so reduces the chance of abuse and addiction to these powerful drugs.
- Physical and/or occupational therapy: Supervised exercise programs from these disciplines can improve core strength and range of motion. Also, you may receive advice about adaptive equipment or modifications in routine behaviors that can assist with symptom management.
- Cognitive-behavioral therapy (CBT): This popular form of talk therapy can aid with the psychological effects of chronic pain and issues associated with long-term disability.
When Revision Spinal Surgery May Be Necessary
Serious complications after an initial surgery may need immediate revision spinal surgery. Symptoms include:
- New or worsening nerve problems like shooting pain, numbness, or muscle weakness
- Bladder or bowel dysfunction
- Cauda equina syndrome
- Increased spinal instability or pseudoarthrosis
- Spinal instrumentation that has broken or moved out of place
- An infection in the spine
What if you don’t show signs of these more serious conditions? Do you still need surgery?
Ultimately, it depends on you and the advice of your doctor. As an informed patient, you want to explore every treatment option available and find what may work best for you. This means establishing an open dialogue with your doctor.
Things to ask your doctor before revision spine surgery:
- What are the risks of this surgery?
- What are the potential benefits?
- Are there any alternatives I should try first?
- What is the success rate of my particular revision back surgery?
- If I don’t have surgery, what may happen?
Make sure your doctor takes the time to answer all of these questions and review any diagnostic information to support the need for revision spine surgery. If necessary, get a second—or even a third—opinion to ensure that you are making the best choice.
Revision Spine Surgery: What to Expect
As you know by now, there isn’t a single spinal revision surgery that works best. It depends on your diagnosis, other medical conditions, and expected outcomes.
Let’s take a look at a couple of common scenarios in which revision spine surgery is used:
- Extending a previous spinal fusion to address degenerative changes
- Adding extra surgical instrumentation to the spine to eliminate instability
- Removing instrumentation or hardware that causes added pain or infection
- Removing infected or scar tissue
- Creating intentional spinal fractures to restore alignment or stop progressive deformity
- Relieving pinched nerves by removing tissue or bits of bone that cause compression
Depending on what your revision spine surgery endeavors to achieve, these can be either open or minimally invasive procedures.
If you are a candidate for a minimally invasive revision spine surgery, the procedure may be easier than you think. Those undergoing minimally invasive spine surgery experience less pain and quicker recovery times thanks to less damage to nearby tissues. Also, you can expect less scarring and reliance on pain medications during recovery.
Is Revision Spine Surgery Right for You?
The decision to undergo another surgery isn’t easy. Why not work with a multidisciplinary team that will help you make an informed decision based on your personal goals?
The Advanced Spine Center believes a team approach is best. And, of course, you are a crucial member of the team. After all, it’s your body and life. Let us provide you with an accurate diagnosis and all the information you need to determine if revision spine surgery is right for you.
Our doctors have over six decades of experience in treating even the most complex spinal conditions. In fact, our hard work has also earned each surgeon a coveted “Top Doctor” award from New Jersey Monthly Magazine.
Why not schedule a consultation to find out how we can help you? Give us a call today at 973-538-0900.