Dr. Charles Schuster, D.C. breaks down what Failed Back Surgery Syndrome is and why it’s so prevalent.
Although more than 50% of primary spinal surgeries are successful, no more than 30%, 15%, and 5% of the patients experience a successful outcome after the second, third, and fourth surgeries, respectively . The prevalence and incidence of patients with FBSS are comparable with those of patients with rheumatoid arthritis. However, patients with FBSS and neuropathic pain experience higher levels of pain and a poorer quality of life and physical function compared with those with osteoarthritis, rheumatoid arthritis, complex regional pain syndrome, and fibromyalgia .
We all know surgeons are amongst the smartest and most diligently trained people on the planet so why is there such a high rate of failures when it comes to back surgery?
Several factors really and none greater than the actual problem which is usually a bulging or herniated disc. When you take a portion of the spine out, it weakens it. Whether bone is removed or whether the disc itself is removed, the end result is a weaker spine. This leads to many of these procedures being fusions in order to reinforce the spine and protect the nerves. While stabilizing a non-living structure may make perfect sense, our spines were meant to move and when they cannot, the end result is swelling and often even more pressure on the nerves that are causing the pain in the first place. For this reason, even surgeries that produce initial relief, often end up with increasing pain and stiffness as time goes on. Lastly, the shift in body weight post surgically often leads to transitional syndrome, whereby the discs above and below the surgical site begin to experience increased incidence of injury wear and tear.
What are the options for someone that has tried physical therapy, chiropractic and other conservative therapies and they didn’t work?
Basically, there are categories of options at this time:
- Pain Management; i.e injections such as steroids and epidurals, over the counter anti-inflammatories, prescription meds such as non-steroidal anti-inflammatories and opioids, and even procedures where the pain nerves are electrically blocked or severed.
- Spinal Surgery, however, the chances for success are about 50% for initial surgery and the numbers go down significantly for each additional surgery.
- Non-Surgical Spinal Decompression: This has the highest rate of success and according to the NIH, it has a 86% success rate and as high as a 90% success rate according to a recent study done at John Hopkins. This advanced therapy introduces a negative pressure into the affected disc without over-stretching the protective muscles and safely sucks the disc back in and rehydrates it.