Failed Back Surgery Syndrome


The debilitating effects of failed back surgery syndrome ...and what can be done about it.

 

Post laminectomy syndrome, also called failed back syndrome, is a continuous and chronic pain that can develop after certain types of back surgery.

FBSS is a significant medical  and  socioeconomic  problem  in  the  US. It  is estimated that  the  failure  rate  for  back surgery is 15-30%.  The   re-operation  rate  is  about   5%. Considering  that   there   are   an   estimated 300,000   new  back  surgeries   a  year  in  the US,  this  represents a significant chronic pain  problem.

Failure  results  when  the  basic surgery does not  eliminate pain. The  patient is therefore left with   pain,  often   involving  both   the back and  legs, which  is unchanged or worse than  prior to surgery.  FBSS may also occur in  the  neck  and  arms  after  failed  cervical spinal  surgery.

The causes of FBSS may be mechanical resulting from  unstable joints  or spinal stenosis,  or non  mechanical involving scar tissue around  nerves.

Treatment

FBSS is often  treated  in a multi-disciplinary fashion   since   patients  who  have  this  syndrome are often in excruciating pain. Medications,   psychological  counseling and physical therapy are the mainstays of treatment.

Epidural Neuroplasty

This  procedure is  performed in  an  outpatient  center or office  and  involves  "breaking up" scar  tissue which  results  from  prior back  and  neck surgery.  With   the  use of x­ray guidance (fluoroscopy) a very small catheter  is  placed  into   the  epidural space and medications are injected to break up the scar tissue and reduce the inflammation, thus alleviating the pain.

Radiofrequency Lesioning (RF)

RF lesioning involves lesioning the nerve to the facet joints of the back or neck with high energy directed through a small needle. This  creates a controlled small destructive lesion of the nerve. Pulsed radiofrequency creates non-destructive (cold) lesions on nerve roots which can reduce arm and leg pain. The procedure is carefully performed by a Pain Specialist who has been trained in this procedure. Spinal pain can be relieved for 3-9 months using this technique.