Failed Back Surgery Syndrome (FBSS): What It Is and How to Avoid Pain after Surgery
Failed Back Surgery Syndrome is the result of an unsuccessful spinal surgery. Even with the best circumstances, spine surgery is no more than 95% predictive of a successful result.
Two main objectives of spine surgery include decompressing a nerve root that is pinched, or stabilizing a painful joint. An anatomical lesion, which is a probable cause of back pain, must be identified before the surgery. The most common reason for a failed back surgery is because the targeted lesion or supposed cause for the back pain was not identified correctly.
Different types of surgery yield different levels of predictability in their success in alleviating pain. A discectomy for lumbar disc herniation is more predictable than a discectomy for a lumbar disc herniation causing lower back pain. In part, successful alleviation of pain depends on selecting surgeries that have a higher probability for success.
Other causes of FBSS are failure to fuse and/or implant failure, problems with lumbar decompression back surgery including inadequate decompression of a nerve root or nerve damage that occurs during surgery, Scar tissue issues such as the formation of scar tissue around the nerve root, and postoperative rehabilitation.
In judging the outcome of the surgery, patients should consider that the nerve root can take some time to heal. This can make it difficult to determine whether the surgery was a success or not. Generally, if recovery is achieved within three months, patients will continue to feel better. If no improvement has been made after three months, it can be judged that the surgery was not successful.