Understanding Failed Back Surgery

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Failed back surgery is a term used to describe a situation where a patient’s surgery for back pain doesn’t resolve the original problem. In some cases, patients may experience worsening pain or discomfort in another area of the back if spinal instability increased after surgery. A pain management specialist can offer a fresh perspective and new options for patients who have experienced less-than-satisfactory results following back surgery.
Why Back Surgery Sometimes ‘Fails’
Back surgery sometimes fails if the first diagnosis wasn’t entirely accurate or if the procedure itself is considered unpredictable, as is often the case with surgery for a herniated disc causing low back pain. With spinal fusion, there are several factors that may cause the fusion not to be successful, especially if there is degeneration at multiple levels of the vertebrae. Back surgery may also fail if scar tissue has formed around nerves since the initial diagnosis or if there is a secondary pain source that wasn’t identified.

Achieving a More Accurate Diagnosis

Another attempt at surgery is rarely recommended until a patient is reevaluated to determine why the procedure wasn’t successful. It’s a process that typically includes another round of image tests to see if anything changed since the initial diagnosis and subsequent surgery. Once another evaluation is made, pain management often involves another attempt at physical therapy and the use of techniques such as deep relaxation, biofeedback, TENS (transcutaneous electrical nerve stimulation), and chiropractic manipulation.
Weighing Options after Failed Back Surgery

If the procedure was elective, meaning there was no urgent need other than an attempt at pain relief after other remedies were unsuccessful, there is usually time to give other non-surgical pain management techniques a chance. Keeping a journal of occurrences of back pain is one way patients can help identify patterns and link back pain with certain activities or movements to help fine-tune treatment plans. The process should be as interactive as possible, with input from the patient and their doctor and the pain management specialist.
Back surgery doesn’t always fail because of an improper diagnosis. In some cases, there are contributing factors, such as underlying conditions like diabetes and high blood pressure, that may lead to disappointing results. The role of a pain management specialist is to present options based on a new attempt at diagnosis. It’s often a combination of treatments, including some not considered previously, that eventually provides meaningful results for patients with persistent back pain.