What is Persistent Spinal Pain Syndrome after Neck Surgery?

Undergoing surgery is a big decision, and one that should never be taken lightly. Although surgical intervention is often the best and necessary course of treatment for instability in the spine, it comes with certain risks and the potential for post-surgical nerve pain, so it’s always best to exhaust all conservative treatments first.

One unfortunate consequence of spine surgery is that you may develop scar tissue formation as well as nerves that may not heal fully that can lead neck pain as well as neuropathy in arms and hands as well as headaches and migraines. 

Studies show that up to 40% of people who undergo spinal surgery report new or persistent pain after the surgery. The phenomenon is so common, it has its own name: failedback surgery syndrome, or persistent spinal pain syndrome When your neck is involved, it’s called failed neck surgery syndrome (FNSS) or post-laminectomy pain. 

Here, Dr. Jay M. Shah, our board-certified interventional pain specialist at New Jersey’s SamWell Institute for Pain Management, takes a closer look at FNSS to help you understand your condition and your options for pain relief moving forward.

Common causes of failed neck surgery syndrome

The  typical causes of FNSS include:

• Improper nerve healing
• New spinal injuries or recurrent herniated discs
• Scar tissue buildup
• Complex nerve pain after surgery that may persist chronically
• Acceleration of spinal inflammation and arthritis at levels adjacent to your surgery

The continuing pain you feel may have less to do with the surgery itself and more to do with what’s taken place since your surgery. 

For example, if you had spinal fusion surgery to stop your vertebrae from moving and causing pain, but the bones didn’t weld together during the healing process, the movement continues and so does the pain. This condition is called pseudarthrosis. 

It’s also possible that your neck surgery was technically successful in addressing the identified problem, but there was a second underlying issue that was not addressed.

If your surgery involved the implantation of screws or other hardware, it’s possible those devices have loosened and shifted, pressing against nearby nerves.

How to avoid a second surgery

Nobody wants to undergo surgery — certainly not twice for the same problem. While revision surgery may be able to resolve your FNSS symptoms, it’s not the only way to get relief.

Dr. Shah offers several highly effective treatments you can try before subjecting your body to another surgical procedure. He bases his recommendations on a thorough examination of your spine, a full understanding of your symptoms and medical history, precision diagnostics, and his extensive experience as one of the country’s most-knowledgeable and skilled pain management experts. 

Depending on the root cause of your post-laminectomy pain, Dr. Shah may recommend any of the following treatments:

Targeted and Image-Guided Epidural injections

If your pain stems from a compressed nerve and is complicated by inflammation, a steroid injection delivered into the epidural space in your spine can bring quick relief. Under precise live X-ray guidance, Dr. Shah locates the precise spot that’s causing your pain and releases the medication. 

The injection has a twofold effect: a local anesthetic numbs the area so your pain subsides instantly, and a longer-acting steroid reduces the inflammation around surrounding disc and nerve issues. 

Facet Joint Medial Branch Nerve block

As its name suggests, the nerve block targets specific nerves that are sending constant pain messages to your brain. Like an epidural injection, a nerve block contains a local anesthetic, but the target is different. Instead of injecting the medication into the epidural space, Dr. Shah releases it near the affected nerves. To make sure he reaches the right nerves, he uses a contrast material that highlights your nerves and allows him to see the site on a large monitor. 

In addition to numbing your painful nerves and bringing immediate relief, nerve blocks can also serve as a diagnostic tool to help identify which nerves are misfiring.

Radiofrequency ablation

If injections don’t deliver adequate relief, or if they pinpointed a nerve that’s consistently sending pain signals, you may benefit from radiofrequency ablation. 

In this treatment, Dr. Shah delivers radiofrequency energy waves that heat up the affected nerves to a precise temperature, which disables them and stops your pain. 

Spinal cord stimulation

For a more permanent solution, Dr. Shah may recommend spinal cord stimulation (SCS), a device that delivers low-voltage electrical currents to your misfiring nerves to block their ability to send pain signals. 

After a week-long trial to make sure SCS works for you, Dr. Shah implants a small generator under your skin and guides the electrical leads from the generator to your nerves. Clinical trials show that SCS offers better results than revision neck surgery. 

If you have post-surgical neck pain, schedule a consultation with Dr. Shah to find out which treatment is best for you. Call either our Colonia or Livingston, New Jersey locations, or book online today.