Failed Back Surgery


Failed back syndrome is a common language name for FBSS (Failed Back Surgery Syndrome). It describes a condition present on certain patients that have bad results following a back surgery. Its naming has no equivalent to other forms of failed surgery.

Affecting more than six million people every year, back pain is a major expense for health contributors. Around 80% of all adults will visit the doctor during their lifetime and request back pain relief. A minor percentage of affected patients will receive back surgery as a treatment form, meant to eliminate and correct the root cause for the pain.

Back surgery has a good success rate, situated at around 95%. It is not that uncommon that the patient undergoing the operation will still have the pain symptoms present afterwards. In some cases, the actual pain inducing anatomical changes are not corrected properly. The surgeon might completely or partially miss some of the target tissue, which will continue to create discomfort. The general causes for this usually involves a less precise or incorrect diagnostic.

A short list of common factors includes:
- Scar tissue is formed around the surgery site, especially when invasive procedures are used
- Poor technique performed by the surgeon
- Performing the surgery without correcting the site that causes pain
- Unnecessary surgery
- The patient is not fit for back surgery
- Incorrect diagnosis
- Complications arising from the procedure

There are thousands of cases of failed back surgery syndrome produced yearly, mostly on young patients that will face chronic pain for years. In some severe cases this may induce unpleasant neuropathy symptoms. The diagnosis of persistent pain is becoming a complex issue, as an increasingly large percent of patients will experience further symptoms.

Treatment in these cases focuses on more conservative measures, starting with rehabilitation and pain management, another surgery being the least expected measure. Exercise, manual therapy, pain medication and cord stimulators are used to attenuate the pain.

A pre-op diagnosis will often be performed by a medical doctor, a physical therapist or osteopathic physician and in some cases even by a chiropractor. Getting the correct diagnosis involves analysis of the patient’s medical history, physical examination, with the now increasingly necessary MRI or X-ray scan. The complete diagnosis should indicate alternate treatments besides surgery, and include it only as a last resort treatment.

Surgeons should understand that failed back surgery is best prevented by eliminating unnecessary surgical interventions.