What to Expect When Your Doctor Is Diagnosing Failed Back Surgery Syndrome

Failed back surgery syndrome is a condition that occurs after back or spine surgery, where the patient continues to have neck or back pain after the surgery. The pain can come back immediately or a month after the surgery.

Symptoms of Failed Back Surgery Syndrome

The main symptom is back and neck pain; in addition, you may experience symptoms like symptoms

• Neurological symptoms like numbness, tingling sensation, and weakness
• Pain in the legs
• Decrease in mobility
• Pain spreads from one area of the body to another, for instance, pain from the neck down to your arm. This pain is known as radicular pain.

Causes of Failed Back Surgery Syndrome

• Recurrent disc herniation
• Technical error during spine surgery
• Incorrect initial diagnosis
• Scar tissue problems
• Post-operation infection
• Spinal instability
• Uncompliant patient

Risk Factors for Failed Back Surgery Syndrome

Many factors influence the success or failure of back or spine surgery. These factors can be pre-operation, during operation or post-operation.

Pre-operation risk factors include;

• Smoking
• Obesity
• Depression and anxiety in the patient
• Poor patient selection by the surgeon, whereby a surgeon selects a patient who has no chance of success after surgery

Risk Factors during the Surgery

• Failing to create enough space around the spinal nerve
• Creating too much space around the nerve leads to spinal instability.
• Failure to remove all damaged disc
• The surgery was performed at the wrong level.

Post-operative risk factors

• Spinal infection
• Spinal nerve root irritation
• Epidural fibrosis

Diagnosis of Failed Back Surgery Syndrome

To diagnose failed back surgery syndrome, your surgeon will first ask for a medical history to link your current back pain to previous back surgery.

History

The doctor will want to know:

• What your initial diagnosis before surgery was
• The type of surgery that was performed
• Where your pain is located
• If you have any other underlying conditions

Physical examination

Your doctor will then do a physical examination to determine and evaluate the source of back pain. They will check:

• Your posture and functioning to check if you have movement restrictions
• Your vertebrae alignment and take note of the surgical scar
• Your muscle power and your range of motion
• Neurological examination to check if nerve damage is the cause of your pain.

Radiology evaluation

Your doctor may then order a radiological evaluation, which involves X-rays and MRI or CT scans. These tests check for spinal alignment, the extent of degeneration, and instability of your spine.

There are newer imaging techniques that your doctor can choose to use for diagnosis. They include:

EOS imaging is a form of X-ray that gives three-dimensional pictures of the entire body, including your spine and the surrounding tissue.

Bone scan– identifies changes in bone like a fracture in the spine. Using this, your doctor can determine if a new injury is the cause of your symptoms.

Final Thoughts

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