Unlike some surgeries, such as removing a tooth or repairing a torn ligament, back surgery is not as cut and dried. Pain is a tricky thing, and even under the best circumstances with the various possible back surgeries, spine surgery is no more than 95 percent predictive of successfully removing the patient’s pain.
When a patient has surgery, but they continue to have pain, there is a term for this — failed back surgery syndrome. This isn’t actually a syndrome, but rather simply a term to describe situations where patients have had back surgery, but they continue to experience pain afterwards.
Since we see many of these patients at Summit Healthcare Pain Clinic Associates, let’s get into this during these toasty July blogs in Slow Low.
What are reasons for failed back surgery?
Spine surgery can really only do two things:
- It can decompress a nerve root that is pinched or compressed
- It can stabilize a painful joint
Unlike a surgery like removing a painfully decayed tooth, you cannot simply go in and cut out exactly what is causing a patient’s pain. Instead, back surgeries seek to change the anatomy that is behind the pain. The goal may be to remove the lamina at the back of a vertebra that is thought to be compressing a nerve root. Or it could be to remove a disc that has herniated and is pushing on the spinal cord or a nerve root.
Prior to these procedures, the probable source of the patient’s pain is identified. This is likely a lesion or something out of the normal that has changed and is now impacting the nerves. This is difficult because pain can radiate far from its source. Plus, the nature of nerves and the ways they can create pain is far from exact.
By far the number one reason back surgeries are not effective in some cases and patients continue to experience pain is because the area/lesion operated on turned out to not be the cause of the patient’s pain. Or at least it wasn’t the entire cause.
Some surgeries can be more predictable
Some forms of back surgery tend to have more predictable results.
A microdiscectomy for a lumbar disc herniation that is causing leg pain is highly predictable and will likely have good success. The nerve creating the leg pain is easy to identify. That same procedure for herniation that is causing lower back pain has far less likelihood of successfully removing most or all of the patient’s pain. That’s because the nerve or nerves involved in the lower back pain are far from easy to isolate and identify.
If you’re having continuing pain even having back surgery performed elsewhere, Dr. Trujillo can help with your pain. Please call us at (855) 768-4968 and let’s see how we can help and keep you from having another surgery.