Failed back syndrome refers to surgery that has failed. This means it’s also called failed back surgery syndrome (FBSS). It’s not really a syndrome; it’s a term to describe the condition that patients experience when they haven’t had successful back or spine surgery or they have experienced a great deal of pain after surgery. There are many reasons why this occurs, even when the best surgeon is standing at the table.
Why Back Surgery Can Fail
There are two reasons why back surgery may be needed. The first is to stabilize a joint that is painful or decompress a pinched nerve root. Unfortunately, there are times when spine or back surgery can’t eliminate all of a patient’s pain. It is meant to change the anatomy of an injury or the cause of the pain in an effort to bring back relief and improved mobility.
One of the most common reasons why back surgery fails is because the injury that was operated on may not have been the cause of the pain. It is possible to have other injuries and those injuries not produce pain.
Effectiveness of Surgery on Back Pain
Some types of back surgery are expected to produce positive results. For example:
- Spinal fusion is performed for spinal instability. However, when fusion surgery is done for multi-level lumbar degenerative disc disease, the chances of success in relieving pain are not as great as with other conditions that need spinal stability to get better.
- Discectomy is designed for relieving a herniated disc that is triggering pain in the leg and back. However, a discectomy for lower back pain may not be as successful as a discectomy in the middle or upper back.
Predictability of a surgery plays a very important role in whether the surgery is performed in the first place. This is why back and spinal surgeons will sometimes stick with the surgeries that offer a high degree of predicted success unless there is an absolute need to take a chance. In that case, it is important for the surgeon to be realistic with the patients about results so patients can make informed decisions.
Causes of Failed Back Syndrome
There are other reasons why surgery can fail or pain continues. For instance, fusion surgery may not work because there is fusion failure or the lesion is transferred to another level, causing pain. If decompression back surgery is performed, it is possible for the nerve damage not to heal following the surgery, which can cause pain. There may also be scar tissue or the postoperative rehabilitation may be painful in itself.
It is very important to talk to your surgeon about the possibilities. If there is a good chance that surgery will work, then you may be faced with a very important decision. If there is a high probability that surgery won’t work, then other treatment options may be discussed with you so that you can still have a chance at improving your quality of life.