If you have ever received spine surgery, you expect it to relieve pain. If it doesn’t, the continued pain may be discouraging. Fortunately, solutions exist for failed back surgery syndrome. NU-Spine: The Minimally Invasive Spine Surgery Institute offers state-of-the-art treatments, including complex revision spine surgery, at locations throughout New Jersey to help patients get back to pain-free living. Here, our experts discuss failed back syndrome, what causes it, and the treatment options available to patients in pain.
What Back Conditions Are Treated With Surgery?
Back pain is a common complaint. In many cases, it is caused by nothing more than a mild muscle strain or cramp. This pain will improve in a few days, weeks, or months. Non-invasive treatments, such as resting, pain management medications, or physical therapy, may help the recovery process.
However, in some cases, back pain does not improve with time. Chronic pain, or pain that lasts for more than several months, often indicates an underlying health condition. While conservative treatments may sometimes provide temporary relief, long-term solutions must be more targeted. Spine surgery is often recommended for the following chronic pain conditions:
- Degenerative joint disease (arthritis)
- Degenerative disc disease
- Herniated disc
- Slipped disc
- Spinal stenosis
- Radiculopathy (pinched nerve)
- Myelopathy (spinal cord compression)
- Flat back syndrome
- Scoliosis
- Kyphosis
If not addressed, these conditions can worsen over time, and in some cases, lead to long-term, untreatable consequences. Surgical treatment often provides immediate and lasting relief. Patients can go back to pain-free lives and the level of activity they enjoyed before developing a chronic pain condition.
What Is Failed Back Syndrome?
Surgery is usually an effective treatment for chronic back pain. Medical innovations have made most modern procedures extremely reliable. In addition, minimally invasive spine surgery techniques exist to reduce post-operative trauma for an easier recovery.
However, in some cases surgery does not provide the relief that patients are looking for. Failed back syndrome, also called failed fusion syndrome or failed laminectomy syndrome, refers to back pain that returns after surgery. There are many potential reasons for failure, ranging from pre-operative factors to failed implants. Finding a long-term solution requires further diagnosis and treatment. After identifying the issue, the spine surgeon can develop a new treatment plan to eliminate pain permanently.
Causes of Failed Back Syndrome
Several factors contribute to the success of spine surgery. Similarly, failure in any of these areas may lead to an overall failure of the operation. There are, therefore, many potential causes of failed back syndrome, including:
- Misdiagnosis: An incorrect diagnosis may lead surgeons to perform the wrong procedure, which does not correctly address the root cause of pain.
- Co-occurring conditions: While surgery may effectively address one pain condition, a second condition that went unnoticed may continue causing symptoms.
- Progressive conditions: The surgery provided temporary relief, but the pain-causing condition is progressive. Its symptoms continue to worsen after treatment.
- Surgical trauma: While performing the operation, the surgeon causes unintentional damage to the root nerve. This damage causes new neurological symptoms.
- Recovery complications: Infection or other complications prevent the body from recovering as it should, allowing symptoms to linger or causing new ones.
- Scar tissue: Recovery results in scar tissue buildup. The scarring restricts mobility, irritates nearby tissue, or puts pressure on root nerves or the spinal cord.
- Bone fusion failure: The immune system rejects a bone graft. Alternatively, the new bone does not grow correctly, resulting in a weak or incomplete fusion.
- Implant failure: Surgical implants do not always last. Loose screws, old technology, or migrating hardware may result in implant breakdown and new pain.
- Lifestyle factors: Strenuous activity, smoking, and other lifestyle choices may interfere with surgical outcomes to create new or returning pain.
When a patient visits NU-Spine for failed back syndrome, the surgeon begins by identifying the cause. This step is crucial for planning an effective correction. After one spine surgery fails to provide relief, the prospect of a second may sound disappointing. This is why it is vital to ensure that the second procedure is done properly and that a third procedure will not be necessary.
Consequences of Failed Back Syndrome
Failed back syndrome is often painful. In some cases, however, its consequences go beyond mere discomfort. Chronic pain may be accompanied by reduced mobility, bladder or bowel problems, and other symptoms that make it difficult to work, sleep, or participate in favorite activities.
Failed surgeries have an emotional impact, too. Receiving spine surgery is both physically and emotionally difficult. While patients are willing to undergo the challenge to find relief, the process still creates strain. The thought of repeating it after failure is discouraging, and it may seem difficult to imagine a life without pain. Emotional effects of failed back syndrome include:
- Depression or anxiety
- Increased irritability
- Inability to maintain employment
- Disrupted sleep patterns
- Strained relationships
- Financial distress
- Reduced overall health and well-being
To avoid disability and find emotional relief, seeking medical attention is essential. As daunting as a second procedure may be, further treatment is the only way to correct failed back syndrome and create a permanent solution to treatment-resistant back pain.
Diagnosing Failed Back Syndrome
The first step to treating failed back syndrome is diagnosis. The NU-Spine team begins with a thorough review of the patient’s medical history, including any previous diagnoses and procedures. This tells specialists why the patient is visiting and may provide clues into the cause of continued pain. They will then perform a physical examination to locate painful areas, determine the patient’s range of motion, and discover any other symptoms caused by failed back syndrome.
This cursory analysis is often followed by a series of diagnostic tests. NU-Spine uses cutting-edge technology to ensure highly detailed and accurate results. Tests we may use include:
- X-ray: One of the oldest and most well-established imaging technologies, X-rays use precisely targeted radiation to take images of bones and other hard structures.
- Computed tomography: Also called CT scans, these use X-rays to take multiple images of the body in “slices” that can be assembled to form a three-dimensional image.
- Magnetic resonance imaging: Also called MRI, this technology uses strong magnets to take images. It is especially good for diagnosing issues with soft tissue.
- Electromyography: This test helps doctors test nerve function and is useful for diagnosing issues caused by spinal cord compression or a pinched root nerve.
- Bone scan: This procedure uses a small amount of radioactive material, called a radiotracer, to look for bone issues, including infection, cancer, fractures, and arthritis.
Testing results let our team rule out potential causes and identify a proper diagnosis. We employ a thorough process with every patient, ensuring that spine conditions are diagnosed correctly. This precision enables us to plan the most effective treatments possible.
Non-Surgical Treatments for Failed Back Syndrome
When patients visit NU-Spine for failed back syndrome treatment, they may not feel ready to pursue a second surgery. In addition, sites of previous surgeries are often sensitive and vulnerable to additional damage. For these reasons, NU-Spine often begins with conservative treatments. Some of our non-invasive options for failed back syndrome include:
- Rest and reduced activity
- Pain management medications
- Physical and occupational therapy
- Corticosteroid injections
- Radiofrequency ablation
- Supportive braces
- Spinal cord stimulation
Depending on the cause of failed back syndrome, these treatments may prove effective. Even if they don’t address the root cause, they relieve enough pain to let patients lead a higher quality of life while avoiding a second surgery.
What Is Complex Revision Spine Surgery?
As with any other spine condition, conservative treatments aren’t always enough. If failed back syndrome does not improve after non-invasive methods are tried, then surgery may be necessary. Revision spine surgery is a procedure to treat failed back syndrome. It is a complex operation to correct problems with a prior operation.
The process of revision surgery looks different for each patient. For one individual, the surgeon may replace failed hardware or insert fresh bone graft material. For another, he may perform a new procedure to treat conditions that were not addressed by the previous operation. Other patients may need a combination of techniques to make sure their condition is fully treated.
Revision spine surgery requires an experienced spine specialist. With proper care and expertise, however, it can help patients find complete relief from chronic pain. By fixing issues with the previous work, the surgeon lets the patient get back to pain-free living without fear of disability.
When Is Complex Revision Spine Surgery Recommended?
Revision spine surgery is not recommended for everyone. A variety of factors must be considered when deciding on a treatment path, including the condition being treated, the patient’s desired outcome, and their overall health. NU-Spine only recommends surgery when we are confident that it is the best option for our patient. Reasons we may suggest surgery include:
- Quality of life: Surgery is recommended for patients whose chronic pain gets in the way of maintaining a high quality of life.
- Treatment resistance: Surgery is most often recommended after conservative treatments fail to provide relief.
- Physical fitness: Second procedures are physically straining, and therefore most effective on patients who are healthy besides failed back syndrome.
- Risk of disability: Surgery is recommended for patients whose condition may worsen and risk creating other major health complications.
- Test results: Surgery is recommended for patients whose imaging tests confirm failed hardware, a rejected bone graft, or spinal instability.
If one or more of these are true for you, then complex revision spine surgery may be an option. If you aren’t sure, speak with a NU-Spine specialist to learn more about surgery and its risks and benefits.
Who Performs Complex Revision Spine Surgery at NU-Spine?
Because revision spine surgery is complicated and personalized, it requires a skilled specialist. The surgeon must have extensive experience to correctly diagnose failed back syndrome and treat a part of the back that is already vulnerable.
Patients at NU-Spine receive treatment from the world-renowned neurosurgeon Dr. Branko Skovrlj. He is a specialist in all kinds of spine surgery but specializes in minimally invasive surgeries and complex procedures like revision surgery. He routinely contributes to research efforts to improve spine condition diagnosis and treatments. These contributions have earned him multiple awards and the respect of neurosurgeons and medical organizations around the globe.
Despite his accolades, Dr. Skovrlj remains down-to-earth and approachable. He takes the time to build relationships with his patients, getting to know them beyond their pain. This makes it easier for patients to discuss their condition and trust him to provide effective treatment.
Outcomes of Complex Revision Spine Surgery
After complex revision spine surgery, Dr. Skovrlj will provide guidance for recovery. It is extremely important that patients follow his directions, which may include restricting physical activity, protecting surgical sites, and monitoring for signs of infection. These instructions are meant to prevent complications that may lead to a second surgical failure. Following them carefully gives the patient a better chance for a successful recovery and long-term relief from pain.
Revision spine surgery outcomes can vary. Some patients experience immediate and permanent relief from chronic back pain. Others experience partial improvement. Generally, the chances of successful surgery decline with each new procedure, which means a complete recovery is not guaranteed. Fortunately, Dr. Skovrlj’s procedures have a high chance of success. Patients can discuss potential outcomes with him when deciding on a treatment path.
Find Revision Spine Surgery Near You in New Jersey
Continued pain after surgery can be overwhelming, but solutions exist. NU-Spine: The Minimally Invasive Spine Surgery Institute offers complex revision spine surgery at locations near you across New Jersey. Contact us today to learn more or schedule an appointment at one of our New Jersey locations near you.