More About Failed Back Surgery Syndrome

istock 1171010146 1
istock 1171010146 1

In this month’s first blog, we got into the problem where a patient has had spinal surgery but continues to have pain. The term for this is failed back surgery syndrome. This is not a true “syndrome,” such as carpal tunnel syndrome, but more of an overall term. Regardless, ongoing chronic pain after back surgery is difficult and disappointing. 

In July’s second blog, let’s get into this a bit more, especially in the situations of lumbar decompression surgeries. 

Time frames for success 

When a person has a surgery to relieve nerve compression in the lumbar spine (procedures such as microdiscectomies or laminectomies) the nerve roots have been compressed and at least partially damaged. They take some time to heal, even after the source of the decompression seems to have been removed. 

  •     In general, if a patient is getting better within three months of the surgery, he or she should continue to get better.
  •     If there has not been any improvement in the pain approximately three months after the decompression procedure, then the back surgery can be assumed to be unsuccessful and further action will be necessary.
  •     During the first three months after surgery, the success of the procedure cannot be judged, as enough time has not passed to allow for healing and decreased inflammation.

Considerations 

There are a couple other things to consider with these lumbar procedures. 

Decompression of the lumbar spine will usually relieve the patient’s leg pain directly after the surgery. However, for 10-20% of patients, the pain will continue until the nerve starts to heal. In some cases, the pain may even be worse for a while after the back surgery because operating around the nerve root creates some increased swelling and this leads to pain. 

It usually takes far longer for symptoms of numbness, tingling, or weakness to resolve. It may take up to a year after surgery for these symptoms to subside. If these symptoms persist after a year, they probably are signs of permanent nerve damage and they are now unlikely to improve in any length of time. 

Also, after decompression surgery, such as a discectomy, the stenosis can return at the same vertebra or at a new level. After all, the conditions that caused the initial development of compression and bone spurs may still be present. 

Pain that is relieved right after surgery but then returns abruptly is often due to recurrent lumbar disc herniation. Recurrent lumbar disc herniations happen to about 5% to 10% of patients, and they are most likely to occur during the first three months after the patient’s back surgery. 

If you’re still having pain after your back surgery, that’s something we can help with at Summit Healthcare Pain Clinic Associates. Call us at (855) 768-4968 to schedule a consultation with Dr. Trujillo.

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