What is Failed Back Surgery Syndrome?

Failed back surgery syndrome (FBSS) is a condition that develops when a surgery on the spine does not work as expected. This term is an umbrella term referring generally to failed surgeries, rather than a specific medical diagnosis. If a patient has failed back surgery syndrome, there are a number of treatment options that can be considered. The patient will need a thorough diagnostic evaluation to learn more about why the surgery failed and what is happening with the patient's spine. This can include medical imaging studies, as well as physical exams.

Spinal surgeries can be performed to decompress the spine, repair unstable joints, fuse the spine in cases where vertebrae cannot be repaired, and address herniated and slipped discs. The goal of the surgery is to address the problem causing symptoms for the patient. Patients with back problems can experience pain and numbness in both the back and the extremities. There are a number of reasons that a surgery may not succeed. Some patients are poor candidates for surgeries; in other cases, surgeries are not performed well, and in some situations, patients simply fail to respond to the surgery as expected.

If the surgery does not work, the pain will persist or recur. Back and neck pain, numbness, and tingling can all be reported by a patient with failed back surgery syndrome. Sometimes pain is also in the extremities because a nerve root is involved. The patient may complain of stabbing, shooting, or fiery pains in the legs and arms. The pain is persistent and cannot be alleviated with positional changes and stretches.

Also known as post-laminectomy syndrome, failed back surgery syndrome can become debilitating for the patient. The pain may make it difficult to work, especially if the extremities are involved and the patient cannot walk or move the arms easily. Patients can end up on disability as a result of the chronic pain and may spend much of their time on bed rest.

Treatments for failed back surgery syndrome can include narcotic drugs for pain management, which may be taken orally or delivered with an infusion pump. Patients with severe pain can benefit from pumps that deliver steady and targeted doses to the area. Some patients experience relief with electrical stimulation of the nerves in the area. Other options can include a neurotomy to sever a nerve that is sending pain signals relentlessly, or a repeat surgery to attempt a repair. Second surgeries are recommended if there is clear evidence that a surgery would be beneficial to the patient, but not in cases where there are no obvious indications for surgery.