A patient, whose condition does not improve after spine surgery or who develops new symptoms after initial “successful” surgery may be found to suffer from Failed Back Surgery Syndrome (FBSS). The incidence of FBSS is estimated to be as high as 40% and multiple factors may cause or contribute to the development of this complex syndrome.
Possible Causes of FBSS
Possible causes include, but are not limited to central canal, lateral recess or neuroforaminal stenosis, recurrent disc herniation, spondylolisthesis, epidural fibrosis (i.e. formation of scar tissue near a nerve root), arachnoiditis (inflammation / irritation of the spinal cord’s arachnoid membrane), other musculoskeletal or neuropathic pain syndromes, and psychological disorders.
Failed Back Surgery Syndrome Treatments
Treatment of FBSS requires careful consideration with clear and reasonable goals in mind. Neurosurgeons at Boulder Neurosurgical & Spine Associates (BNA) believe that surgery is not always the best treatment for all patients. Our therapeutic approach to the treatment of structural and nonstructural spine problems in a patient who has FBSS varies.
A structural cause is clearly identified before surgical intervention can be considered. The type of surgical intervention (i.e. decompression, fusion) is recommended based on the individual patient to specifically treat the underlying cause of failed back surgery syndrome.
If FBSS is related to a nonstructural problem, appropriate treatment may involve a functional solution such as spinal cord stimulation (SCS).