Spine surgery is often a patient’s last resort when it comes to dealing with back pain. When that surgery does not provide the desired results and leaves the patient with persistent pain, this is called failed back surgery syndrome. According to a 2020 study published in the Journal of Orthopaedic Surgery and Research, one in five patients to undergo lumbar spinal surgery experiences persistent pain within two years of their surgery date. This common condition is a frustrating and often debilitating risk of spine surgery, but treatment options are available.

What are the symptoms of failed back surgery syndrome?

A patient that has undergone spine surgery and experiences persistent pain afterward may have failed back surgery syndrome. This chronic pain may be experienced in areas other than the back, including the legs and neck. The pain may occur directly after surgery, or it may develop slowly during the recovery process. The pain of failed back surgery syndrome may be more or less intense than the pain that the patient was experiencing before surgery.

What causes back surgery to fail?

No type of surgery is 100% guaranteed. Even if the surgery is performed flawlessly, problems can occur that may prohibit appropriate healing and, therefore, positive results.

Some causes of failed back surgery syndrome include:

  • Complex surgeries that have a higher than usual failure rate, such as fusion surgery for lumbar multi-level degenerate disc disease
  • Implant failure
  • Infection
  • Nerve injury
  • Degenerative disc disease
  • Inadequate decompression of a nerve
  • Development of scar tissue that compresses a nerve
  • Failure of spinal fusion after spinal fusion surgery
  • Degeneration of a nearby disc, vertebrae, or joint after spinal surgery

Spinal surgeries that may lead to failed back surgery syndrome

Any type of back or spine surgery has the potential to lead to failed back surgery syndrome.

Laminectomies, discectomies, lumbar decompression surgery, spinal stenosis surgery, and spinal fusion surgeries may all result in failed back surgery syndrome.

Failed back surgery statistics

As back surgeries become more common, so does the prevalence of failed back surgery syndrome. An aging population, as well as the expanded use of spinal surgeries for back pain, means that more patients than ever are experiencing failed back surgery syndrome.

  • Up to 40% of back surgery patients have continued pain after surgery
  • Up to 40% of lumbar laminectomy surgeries may result in failed back surgery syndrome
  • Up to 36% of discectomy surgeries for a lumbar herniated disc may result in continued pain

Studies show that the likelihood of failed back surgery syndrome increases with every subsequent back surgery. According to the National Center for Biotechnological Information, success rates for back or spine surgery are as follows:

  • 50% for primary surgeries
  • 30% for second surgeries
  • 15% for third surgeries
  • 5% for fourth surgeries

Treatment for failed back surgery syndrome

When a patient is suffering from failed back surgery syndrome, the first course of action is to get the patient’s pain under control. Managing the pain of failed back surgery syndrome may involve injections, nerve blocks, and other treatments that stop the nerves from sending pain signals to the patient’s brain.

Once the pain of failed back surgery syndrome is under control initially, other treatment options may be added to the treatment regimen with the goal of long-term pain relief. Some treatment options for failed back surgery include:

Physical therapy – Physical therapy is used after failed back surgery to help manage pain, improve mobility, reduce inflammation, increase flexibility, and build strength and endurance.

Spinal cord stimulation – If failed back surgery syndrome includes pain that radiates into the arms or legs, spinal cord manipulation may be an option. Spinal cord manipulation uses an implantable device to send gentle electrical pulses to the nerve roots that are causing pain. These electrical signals mask the pain signals and provide relief.

Pain-relieving medication – Some patients are best served by pain-relieving medications, including oral opioids or intrathecal pain-medicine delivery pumps.

Spinal cord injections – Epidural and facet joint injections are often used to treat lasting back pain.

Revision surgery – Depending on the cause of the failed back surgery syndrome, some surgeons will recommend a second surgery to repair the cause of the ongoing pain.

Suffering from failed back surgery syndrome?

For more information on failed back surgery syndrome, or to have your back pain evaluated by one of our board-certified orthopedic surgeons, please click on “Connect with a Doctor” now. BICMD’s nationwide network of orthopedic surgeons can help you decide which treatment is best for your back pain. Our physicians are top orthopedic doctors hand-picked from reputable organizations nationwide and are extremely skilled with failed back surgery treatment options.