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Post-Surgical Back Pain (Failed Back Syndrome)

Failed back surgery syndrome (also called FBSS, or failed back syndrome) is a misnomer, as it is not actually a syndrome - it is a generalized term that is often used to describe the condition of patients who have not had a successful result with back surgery or spine surgery and have experienced continued pain after surgery.

Spine surgery is basically able to accomplish only two things:

  • Decompress a nerve root that is pinched, or
  • Stabilize a painful joint.

By far the number one reason back surgeries are not effective and some patients experience continued pain after surgery is because the lesion that was operated on is not in fact the cause of the patient's pain.

  • Fusion surgery considerations (such as failure to fuse and/or implant failure, or a transfer lesion to another level after a spine fusion, when the next level degenerates and becomes a pain generator)
  • Lumbar decompression back surgery considerations (such as recurrent spinal stenosis or disc herniation, inadequate decompression of a nerve root, preoperative nerve damage that does not heal after a decompressive surgery, or nerve damage that occurs during the surgery)
  • Scar tissue considerations (such as epidural fibrosis, which refers to a formation of scar tissue around the nerve root)
  • Inadequate Postoperative rehabilitation

When pain persists after back surgery, the true cause of the patient's pain needs to be re-evaluated. It may be the case that the surgery was performed to address an issue that was not the true pain generator. It may also be damage from the surgical procedure itself that is causing pain. In a spinal fusion surgery, the mechanical changes to the spine may cause new pain to develop. All these things are considered to evaluate the cause of the post-surgical pain. Spine Specialists at Capri can help in thorough evaluation of such patients using CD-SSAT and thereby providing adequate rehabilitation for the same.