Failed Back Surgery (FBSS)

Failed Back Surgery Syndrome is simply back pain that persists or begins after back surgery. Most often, this pain is associated with laminectomy surgery but may be associated with any type of back surgery.  

Symptoms:

Common symptoms include pain at the surgery site; dull, aching pain involving the back and legs; and sharp, prickling, stabbing pain in the extremities. The pain may feel similar to the pain felt before the surgery, or it may be new sensations radiating to different areas of the body.

Causes:

FBSS is most commonly caused by an incorrect preoperative diagnosis of the cause of pain. Another frequent cause is improper or inadequate postoperative rehabilitation. Unfortunately, the cause of continued pain may be that the nerve root simply does not recover from the trauma prior to the surgery. Pain may also be caused by structural changes that occur in the spine as a result of the surgery. These changes may cause the pain to be above or below the site of surgery or, less commonly, new scar tissue may put pressure on nerve roots.

Testing:

A thorough clinical evaluation to diagnose the exact cause of pain is critical. Your interventional pain physician may order imaging studies such as a CT or MRI. Additionally, your interventional pain physician can utilize injection techniques to identify the precise location and cause of your pain. Identifying the correct diagnosis is key to determining effective treatment.

Treatment:

Treatment for FBSS is dependent on the diagnosis. Common therapies for FBSS include:

• Physical Therapy
• Chiropractic Treatments
• Epidural Steroid Injections
• Selective Nerve Root Blocks
• Radiofrequency Nerve Ablation
• Spinal Cord Simulator
• Intrathecal Pain Pump