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What is Failed Back Surgery Syndrome ?
Failed Back Surgery Syndrome (FBSS), also called failed back syndrome, is a general term used to describe the chronic pain that can appear in the aftermath of any back surgery that fails to relieve a preexisting pain-causing condition. A number of different risk factors can contribute to the onset of this condition.
What are the symptoms of Failed Back Surgery Syndrome ?
The symptoms of FBSS may be similar to the pain a patient experienced before his or her initial surgery. These include:
Common symptoms of Failed Back Surgery Syndrome include:
- In the lumbar spine: pain, numbness, tingling, burning, and weakness in the lower back, buttocks, legs, and feet. If impingement affects one of the roots of your sciatic nerve, you can develop sciatica. In extreme cases, a condition called “foot drop,” in which the ability to flex the foot upward is compromised may develop.
- In the cervical spine: pain, numbness, tingling, burning, and weakness in the neck, arms, hands, and sometimes in the head
- In the thoracic spine: pain, tingling, or numbness starting in the upper or mid back and radiating through the stomach or chest, which patients often confuse for cardiovascular problems
Prior to having a surgical procedure to treat your failed back surgery syndrome, conservative measures such as physical therapy, chiropractic, and steroid injections should be attempted. If these measures do not meaningfully relieve your pain, a North American Spine procedure may be in order.
What are the causes of Failed Back Surgery Syndrome ?
Failed back surgery syndrome has a range of possible causes, including misidentification of your back problems before surgery, and the selection of a surgical procedure that has a relatively small chance of reducing or eliminating your symptoms.
Additional common Failed Back Surgery Syndrome causes include:
- Misidentification of problems. Back problems with similar symptoms may have distinctly different underlying sources. This means that a surgical procedure on your back must always be preceded by a careful and accurate process of diagnosis. In most cases, the cause of failed back surgery syndrome is simply misdiagnosis of the origin of your pain or other related symptoms.
- Low-success procedures. Not all forms of back surgery have equal odds of achieving their aims and relieving your symptoms. As a rule, your chances for experiencing a failed back surgery rise when you or your doctor chooses an unproven procedure or a procedure known to have a limited track record of success.
- Scar tissue formation. Scar tissue can cause failed back surgery syndrome if it essentially recreates the original problem by impinging on nerves or nerve roots. Because traditional, open surgery tends to create larger formations of scar tissue, minimally invasive surgery may decrease the risk of FBSS.
- Incomplete surgical results. Even if a surgeon properly identifies the cause of your back-related symptoms, he or she must make sure that this cause is thoroughly corrected on the operating table. For example, if you have a herniated disc pressing against your spinal nerves, pressure from this disc must be completely removed in order to provide relief. Failure to fully ease pressure on your nerve tissue can lead to continuing problems in the aftermath of surgery.
Other, less-common causes for the onset of failed back surgery syndrome include a recurrence of the original cause of your symptoms, collateral nerve damage caused by a surgeon during a corrective operation, permanent nerve damage from the original source of your problems, and the appearance of pain from another source following surgery.
What is the treatment like for Failed Back Surgery Syndrome ?
Treatment and procedure options for Failed Back Surgery Syndrome range from conservative options like injections to more intensive procedures like spinal fusions.
Conservative Options Conservative treatment options include nerve root blocks and steroid injections. These are designed to provide temporary relief (up to one year), and you may elect to have the procedure done multiple times. Other conservative strategies may include the placement of a spinal cord stimulator–or STIM–which is designed not to correct the underlying degeneration, but to lessen the pain the condition causes.
Decompression Decompression may be used for cases in which the structural integrity of the vertebrae or spinal cord is not threatened. These procedures concentrate on freeing entrapped nerves, typically be enlarging the space through which nerves pass. Depending on the demands of the procedure and your unique physiology, a special surgical laser may be used.
Fusion/Stablization Fusion, also called stabilization, procedures may be used when the stability of the spine or vertebrae are compromised or threatened. In some of these cases, more than one harmful condition may exist. While these procedures are minimally invasive and enjoy a high success rate, some patients may be required to stay overnight for observation.
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