Failed Back Surgery Syndrome (FBSS) refers to a condition where a patient continues to experience persistent pain or other symptoms following one or multiple spine surgeries. Despite the surgical intervention, the individual may not experience the expected relief or may even develop new symptoms after the procedure.
Back pain is more common as people get older and is more likely in females. As folks get older, more surgeries for lower back pain happen. For instance, the number of main surgeries to fuse the lower spine went up by a lot, about 170%, from 1998 to 2008.
After surgery, things like the spine wearing down over time, new spine problems, and added pressure on areas close to where the surgery happened can cause Failed Back Surgery Syndrome.
The operation might make the existing pain worse or create new issues in the spine that make the treated area or nearby parts unstable. Sometimes, the bones might not heal together properly after the surgery, or the implants used might not work well, leading to ongoing pain, less ability to move, or new problems.
When a part of the spine is fused, the areas around it have to work harder when moving because that fused part can’t move like before. This extra work can make the nearby parts wear out faster, causing pain and other issues. This is more likely to happen with surgeries that involve fusing multiple parts of the spine.
Several factors could contribute to the development of Failed Back Surgery Syndrome, including:
- Incomplete Resolution of the Problem: The surgery might not completely address the underlying issue causing the pain, leading to persistent symptoms.
- Nerve Damage or Irritation: Surgical procedures involving the spine can sometimes result in nerve damage or ongoing irritation, causing pain or discomfort.
- Scar Tissue Formation: After surgery, scar tissue can form around the surgical site, potentially causing compression of nerves or tissues, leading to pain.
- Improper Diagnosis: Misdiagnosis or incomplete understanding of the actual source of the pain can result in unsuccessful surgical intervention.
- Degenerative Conditions: In cases of degenerative spine conditions, such as arthritis or disc degeneration, the surgery might not fully alleviate the ongoing pain due to the chronic nature of these conditions.
- Psychological Factors: Emotional stress, anxiety, or depression can exacerbate the perception of pain, complicating post-surgery recovery.
The success rates of revision surgeries also decrease with the number of returns :
- Up to 50% of spinal surgeries may be successful when performed for the first time
- Up to 30% of spinal surgeries may be successful when performed for the second time
- Up to 15% of spinal surgeries may be successful when performed for the third time
- Up to 5% of spinal surgeries may be successful when performed for the fourth time