Definition – What is Failed Back Surgery Syndrome (FBSS)?
Failed back surgery syndrome (FBSS) refers to a subset of patients who have new or persistent symptoms after spinal surgery. Despite its name, FBSS does not mean that there was a problem during the initial surgery. However, it does imply that there is continued pain.
Failed back surgery syndrome refers to chronic neck or back pain with or without arm/leg symptoms. Symptoms can be nonspecific and diffuse which may seem different from the initial presentation prior to surgery. Common symptoms also include the following:
- Diffuse, dull, achy pain
- Leg or arm pain
- Sharp, burning or stabbing pain
- Numbness and tingling
It is important to reassess patients with chronic pain after back surgery. The most important step is to complete a thorough history and physical examination to help to localize the problem. In the case of a fusion surgery, the adjacent segments have to move more which can cause irritation and pain. Another common surgery is a discectomy, which involves removing a part of the disc. After this procedure it is not uncommon for continued pain. There are nonsurgical options for treating FBSS as discussed below.
Medications can be prescribed for pain management and symptomatic treatment including acetaminophen, nonsteroidal anti-inflammatories, and muscle relaxers. There are some medications that are specific to nerve pain which include symptoms of burning, tingling and numbness. Another important aspect of treatment is therapeutic exercise during physical therapy.
There is evidence that the use of spinal cord simulators (SCS) in patients with FBSS has been beneficial. Studies have shown improvement in both pain and function after this procedure. This may be an option for those with chronic pain who have not found relief with other therapies. If you are interested in being evaluated for chronic pain after back surgery, please give us a call and schedule an appointment.
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