Treatment Options for Failed Back Surgery Syndrome

Failed back surgery syndrome (FBSS) is a term to describe the condition of patients who have had unsuccessful results after spine surgery when treating back and/or neck pain. The continuing or worsening of pain results from more deep-rooted problems with failed spine surgery, which lead to, or creates, more significant problems.

Incidence and Prevalence

Surgical treatment is good for a fast recovery from chronic back pain. However, one side effect of spinal instability occurs after surgery, as it widens the spaces between the vertebrae. The failure rate following spine surgery is around 40%.


Certain conditions can increase the risk of developing FBSS, even though failed back surgery syndrome doesn’t always develop after spine surgery.


  • Not properly identifying the conditions. For example, in hip osteoarthritis, the symptoms of this condition and FBSS are very similar, which may lead to the wrong diagnosis. The physician might perform surgery at the wrong level of the spine or improperly treat the condition, which may lead to FBSS.
  • There is also failure to properly decompress a nerve root or treat the condition.
  • Technical errors, such as herniated disc material being left behind during surgery, or bone fragments, may press on a nerve root or spinal cord. This may result in continuing pain which may worsen after surgery.
  • Implant migration. Many times an implant can shift after surgery before it takes hold of the vertebrae. If an implant is moved, it will be less effective in stabilizing the spine. It can also create a painful spine condition if the implant compresses sensitive neural tissue.
  • Spinal fusion failure. Spinal fusion procedures is performed to relieve nerve compression by removing a damaged disc. The goal is to stabilize the adjacent vertebrae with bone grafts or implants that are naturally fortified as the body heals after surgery.
  • Nerve damage. Many times, after decompressing a nerve root through spine surgery, temporary inflammation can lead to increased pain until the inflammation subsides. Pain and weakness may also occur.
  • Scar tissue formation. A condition called epidural fibrosis can lead to postoperative pain and FBSS. This condition occurs when a nerve root is decompressed through spine surgery and cause temporary inflammation. This can lead to increased pain until inflammation goes away.



Traditional open back surgery has a 40% rate of failing. This means almost half of patients who have surgery do not get pain relief. If you have FBSS, you may develop different degrees of symptoms which include:


  • Pain around the surgery site which shouldn’t be affected.
  • New pain symptoms of the spine.
  • A chronic pain or continuation of pain.
  • Recuperating to slowly or not at all.
  • Mobility limited
  • Extremities experiencing stabbing or sharp pains
  • Dull pain or aching pain in the back, legs or neck.
  • Spasms
  • Immobility of spinal joint
  • Depression
  • Prescription drug over usage
  • Anxiety


Diagnosis and Treatment

Follow-up visits after surgery are a must. During these times, it’s good to talk about how you are feeling, and describe what if any pain in continuing. Talk to the doctor about any concerns, whether you believe they are important or not. He or she will do follow-up visits/exams and test to further treat you.

Patients have an effective alternative for treating FBSS in the form of minimally invasive spine surgery. This procedure is different from invasive spine surgery. Minimally invasive surgery is  performed by skilled surgeons, and it is preferred over open spine surgery. The procedure provides many advantages over open spine surgery, which required large incisions and muscle manipulation. This procedure also involves less muscle disruption. The minimally invasive spine surgery requires only a small incision, muscle sparing techniques, and shorter recovery time.

Dr. Zamfirov at All Star Pain Management offers exceptional back pain treatment for those with failed surgery and dealing with chronic pain. This includes several options such as medication management and interventional treatments. This may include anti-inflammatories, opiates, epidural steroid injections, radiofrequency ablation. As a last resort, a spinal cord stimulator implant may be a great option for relieving back and/or leg pain.

Most insurance is accepted, call All Star today to attain relief!