Failed Back Surgery Syndrome
March 7, 2011 by Dr. Marc Darrow, M.D.
Filed under Back Pain
Perhaps the most distressing is “failed back syndrome” — an official-sounding term to describe the pain of those poor patients whose surgical attempts have failed to correct their problem.
Even before medical school, I watched surgical procedures as much as possible. I wanted to become a surgeon since I wanted to heal.
In medical school, I did surgical research and assisted in the operating room more than my classmates. There was nothing better than a quick fix. Cut the skin, open up the body, fix the problem, and suture it back up.
By the time I had finished medical school and internship (where I spent as much time as possible doing orthopedic procedures) I had seen too many surgical failures.
The most common cause of failed back syndrome is poor judgment on the part of the physician. Surgery prescribed as a last resort, with a hope and a prayer that it might alleviate the pain.
Unfortunately, often times surgery does little to help, and in fact can make things worse. Frequently surgery results in post-operative scarring, which often exacerbates the initial problem or causes new pain syndromes.
Subsequent “corrective” surgery can help in some cases, particularly if the damage done by the first operation involves clearly observable physical complications like nerve root compression, massive scarring, bone spurring or foraminal compression.
Unfortunately, the rate of success for second surgical operations in the case of “failed back syndrome” is no greater than it was for the initial operation, and declines with further attempts. In the words of a surgeon involved in such procedures, “In our extensive experience, satisfactory outcome is achieved about 60% of the time. Evidence indicates that many patients suffering from residual pain after multiple operations can benefit from an intensive rehabilitation program.”
Why Would Back Surgery Fail?
1. The surgery itself damaged previously undamaged ligaments and muscles.
2. Relieving nerve impingement may cause instability in the spine.
3. The surgery did not address the problems causing the initial pain.
4. Fusion of the vertebrae causes breakdown of the areas above and below the fusion.
5. Scar tissue may grow unto the nerves and cause nerve impingement.
I estimate that 95% of the people we see in our clinic have loose and damaged ligaments. This is why when a patient comes in, we examine them with our hands first and not with MRI. Touching the patient at various points on the back helps recreate their pain and allows us to address the exact spots causing it.
