Telltale Signs of Failed Back Syndrome

Failed back surgery syndrome (FBSS), also called failed back syndrome or post-surgical spine syndrome, is a generalized term used to describe the condition where lower back pain persists or appears after spinal surgery. The pain can start immediately following surgery or a few weeks or months later.

Research suggests that the risk for FBSS increases as the complexity of spinal surgery increases. For example, lumbar spinal fusion is a complex procedure and has a higher risk of failed back syndrome (30% to 46%) compared to a microdiscectomy, which is simpler (19% to 25%).

The board-certified pain management providers at Integrated Spine and Pain Services offer customized relief for failed back surgery syndrome using innovative treatments that can help. Here, our team discusses the telltale signs of FBSS so you'll know when to seek medical attention.

Causes of FBSS

There are any number of reasons for failed back surgery syndrome, including:

• The area treated isn't the cause of pain
• Recurrent disc herniation
• Recurrent spinal stenosis (narrowing of canal)
• Inadequate nerve root decompression
• Incomplete healing after spinal fusion
• Continued spinal degeneration above or below the surgical site

There may be other causes, too, which is why the Integrated Spine and Pain Services team carefully reviews your history and test results to determine the exact reason for your continued pain. That allows them to design the best recovery plan for you. 

Telltale signs of FBSS

You may experience signs of FBSS immediately after surgery, or they may develop after a few weeks, months, or even years.

Some patients feel better immediately following the surgery; then the pain gradually develops after a few weeks. Others feel either the same or worse after the procedure.

The pain can be localized to the back or leg or take root in both areas. It may be similar to the pre-surgical pain you had or feel different. Other motor and sensory symptoms, like numbness, weakness, and tingling, may also recur or develop as new symptoms.

Compression of the L5 nerve root in the lumbar spine, which causes foot drop, is common in FBSS. L5 nerve root compression is also responsible for sciatica.

Preventing FBSS

Minimizing the chances of FBSS involves the input of the surgeon, patient, and the rehabilitation team, who consider all the case factors before proceeding. The risk of FBSS may be minimized by:

• Determining the exact cause of the patient's back pain through diagnostic tests before surgery

• Ensuring the diagnostic findings match the related symptoms
• Identifying patients at a higher risk of developing FBSS and trying to address those risks before surgery
• Determining a surgical approach that effectively targets the underlying cause of pain
• Educating the patient on activity restrictions and the importance of physical therapy and exercise during recovery

For those patients who need revision surgery to manage FBSS, we recommend trying several nonsurgical therapies and treatment options before deciding on performing the revision surgery.

If you're struggling with the pain of failed back surgery syndrome, you don't need to suffer; Integrated Spine and Pain Services can help. Schedule a consultation with us at our Falls Church or Alexandria, Virginia offices.