Why You Shouldn't Give up Hope After Failed Back Surgery

You underwent back surgery to fix a problem, but you still have pain or have discovered new pain. Unfortunately, the problem is so common that it has an official medical name: failed back surgery syndrome (FBSS) or post-laminectomy syndrome.  This is also referred to as persistent spinal pain syndrome. 

Back surgery is complex, and although it may resolve the original injury or condition, it may also lead to other problems, such as incomplete healing or spinal instability due to a redistribution of weight on adjacent discs, as well as residual nerve pain from pinched nerves manipulated during surgery. Studies show that FBSS affects up to 20-40% of people following back surgeries like lumbar fusion and discectomies. 

Nerve pain following back surgery is also common. The good news is that Dr. Jay M. Shah at SamWell Institute for Pain Management in Colonia and Livingston, New Jersey, is renowned for relieving FBSS pain with traditional and innovative treatments. 

The most effective treatment depends on the source of your FBSS pain. Dr. Shah examines you thoroughly to determine whether the problem involves nerves, soft-tissue damage, or structural issues. Here are some of the treatments that offer hope, healing, and pain relief for FBSS.

Epidural steroid injections

An epidural steroid injection may be appropriate if your FBSS pain stems from a herniated disc, spinal stenosis, or epidural fibrosis, which is scar tissue that forms on the nerve root after surgery and affects most people after back surgery. 

Epidurals, as they’re called for short, deliver pain-relieving medication right to the source safely under live x-ray image guidance. The procedure contains lidocaine to numb the area and bring immediate relief and a steroid to reduce inflammation and provide longer-lasting relief.

Nerve blocks

Dr. Shah addresses nerve pain in several ways, including nerve blocks, which can be highly effective at interrupting pain signals between your nerves and your brain. When Dr. Shah injects the medication near the targeted nerve precisely under live x-ray image guidance, you feel immediate relief. 

Nerve blocks also serve as a diagnostic tool, helping Dr. Shah identify the precise location of your nerve pain, so that a long-term procedure can then be accurately performed to provide sustained pain relief.

Radiofrequency ablation

If a nerve block successfully reduces or eliminates your FBSS pain, Dr. Shah may recommend radiofrequency ablation, also known as rhizotomy, to stop the nerve’s signals for a longer period.

In this treatment, Dr. Shah uses radiofrequency energy to gently pulse the nerve to, prevent it from sending pain signals. Radiofrequency ablation can typically deliver 6-24 months of pain relief and can assist you in getting back to your normal preventative and maintenance exercise program.

Spinal cord stimulation (SCS)

If you’ve been told you need a second surgery to resolve FBSS, but you can’t or don’t want to undergo another procedure, a neuromodulation procedure might be the solution.

One type of neuromodulation is called spinal cord stimulation. In this treatment, Dr. Shah implants a small device, similar to a pacemaker, under the skin in your lower back region to help stimulate the nerves causing your neck, pain, or neuropathy nerve pain. The device has leads that send low-voltage currents to your affected nerves to stimulate and these nerves at their source and provide long-term pain relief in a more definitive way. 

First, Dr. Shah performs a week-long, non-surgical trial procedure before determining whether you’re a good candidate for the long term implant. This lets us who can expect long-term relief from SCS and who is a good candidate for the therapy. 

Dorsal root ganglion stimulation

Another type of neuromodulation is dorsal root ganglion (DRG) stimulation. The device performs similarly to the SCS device, requires a trial period, and is implanted in the same way, but it targets different nerves. 

The SCS treatment targets general nerves that stem from the epidural space behind your spinal cord. The DRG treatment targets a bundle of sensory nerves in the epidural space and can stop the pain in specific nerves. 

Both treatments can be highly effective, and Dr. Shah determines the right procedure based on your symptoms and diagnostic tests. 

Hope for FBSS

When conservative methods don’t relieve your chronic FBSS pain, don’t despair. There’s hope for lasting relief at SamWell Institute for Pain Management. Contact us online or by phone to schedule an appointment with Dr. Shah, and put FBSS pain behind you.