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Failed Back Syndrome

Failed Back Syndrome

Failed Back Syndrome (FBS) – or Post Discectomy/Laminectomy Syndrome – refers to chronic back or neck pain that can occur after certain types of spinal surgery.

Multiple factors can contribute to the onset or development of FBS. Contributing factors include but are not limited to residual or recurrent disc herniation, persistent post-operative pressure on a spinal nerve, altered joint mobility, joint hyper mobility with instability, depression, anxiety, sleeplessness and spinal muscular deconditioning.

An individual may be predisposed to the development of FBS due to systemic disorders such as diabetes, autoimmune disease and peripheral blood vessels (vascular) disease. Smoking is a risk for poor recovery.

Symptoms

Common symptoms associated with FBS include diffuse, dull and aching pain involving the back and/or legs.

Abnormal sensibility may include sharp, pricking, and stabbing pain in the extremities. The term “post-laminectomy syndrome” is used by some doctors to indicate the same condition as failed back syndrome.

I see this usually in patients who have had a previous discectomy, and the disc degenerates further, becomes inflamed, and causes pain when loaded.

Treatment

Your consultant will review your treatment history, particularly the type of surgery you had and the reasons for it.

Particular attention is paid to the result of the surgery and the symptoms that have evolved following the surgery. A physical exam will be performed, and some further diagnostic tests may be ordered.

Treatment for Failed Back Syndrome may include physical therapy, minor nerve blocks, transcutaneous electrical nerve stimulation (TENS), behavioral medicine, non-steroidal anti-inflammatory (NSAID) medications, antidepressants, spinal cord stimulation, and intrathecal morphine pump. Use of epidural steroid injections may be minimally helpful in some cases. The targeted anatomic use of potent anti-inflammatory anti-TNF therapeutics is being investigated.

In my practice, surgery in the form of a Posterior Lumbar Interbody Fusion is effective in patients with a previous history of discectomy.

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