Failed back surgery, also known as FBSS, is a very generalized term. It refers to anyone who has had back surgery and then continues to still experience pain. Unfortunately, it is seen often, especially in countries where spinal surgery rates are high, such as the United States and Netherlands.
There are many reasons why a patient may not find relief following back surgery. Sometimes, a surgeon can misinterpret the original cause of pain and fix an unrelated issue during the procedure. It is also possible to experience pain after surgery because of fusion failure, a recurrent injury (such as disc herniation), reduced joint mobility, and scar tissue forming around a nerve root.
Diabetes and autoimmune diseases can make it more likely for failed back surgery syndrome to occur. Although it is impossible to predict which procedures will result in failed back surgery syndrome, two of the procedures that seem to result in higher instances are discectomy for lumbar disc herniation causing lower back pain, and spinal fusion for degenerative disc disease.
The pain that is experienced after a failed back surgery can be identical to the original pain or completely different. It can be aching, dull, sharp, or stabbing. It can also result in a prickly feeling in the extremities. Because failed back surgery syndrome is so generalized, virtually any pain, discomfort, or mobility loss following a back surgery can be attributed.
Treatments for failed back surgery syndrome can vary according to the suspected cause of the pain. Options for relief include nerve blocks, nerve stimulation, spinal cord stimulation non-steroidal anti-inflammatory drugs, and intrathecal pump. Sometimes, steroid injections are helpful. Physical therapy can also reduce pain and restore mobility.
Although pain relief may not be permanent or guaranteed, many treatment options can provide relief that lasts a long time and only requires routine maintenance.