When the Last Resort Fails: Failed Back Surgery Syndrome (PMN article details)
See the Pain Medicine News article for full details, but here are some key quotes or points for consideration before having back surgery:
Surgery is a last resort in seeking relief for chronic low back pain— the most common cause of disability — but unsuccessful surgery occurs often enough to warrant its own diagnostic code as failed back surgery syndrome (FBSS)
- While the International Association for the Study of Pain has defined the criteria for FBSS, but Jay Joshi, MD, CEO and medical director, National Pain Centers, Vernon, Ill., offered a simpler version. “The patient ends up having the same or more pain in the same area.”
- Dr. Joshi cited evidence of FBSS occurring in 20% to 40% of cases
- Lumbar back surgery is unlikely to relieve all related pain, Dr. Joshi explained, as the invasive procedure creates its own damage. Although there are techniques to minimize the amount of scarring, it will occur wherever tissue is exposed to air, and with any anatomic change or disruption. “Inherently, you’re going to scar, and you’re going to develop this mass of jumbled up tissue right where the surgery occurs,” he said. “How do you think that’s going to be painless in 100% of the patients?”
- In addition, studies indicate as much as 58% of FBSS results from undiagnosed lateral stenosis of the lumbar spine
It only makes sense to ensure that you've considered all non-invasive treatment options before having a "last resort" back surgery.