Why Back Surgery Fails
(and What to Do About It)
Up to 40% percent of back surgeries fail to reduce pain, and sometimes make it worse. Other surgeries for knees, hips, etc., usually have a 90% chance of success. Failed back surgery is so common it is labeled "Failed Back Surgery Syndrome." What makes lumbar and cervical surgery so unpredictable, and what can be done to improve outcomes?
1. Outdated Surgical Beliefs
Each surgeon has their own analysis of what the problem seems to be and what treatment options may be available. Back pain sufferers typically go from one spine doctor to another searching for relief. Much of Failed Back Surgery Syndrome is related to trial and error.
Surgeons who successfully treat the hardest cases of failed back surgery have demonstrated a core belief: Restoring the natural curve and load-bearing function of the spine must be paramount for the best chance to return to an active, flexible, drug-free lifestyle.
2. Outdated Hardware
Spinal fusion using a "Harrington Rod" was once the medical standard for correcting spinal curvature in the 1960s. Many patients reported decreased mobility with this system. Maintenance surgery was sometimes needed for loosened or corroded screws.
A new hardware solution was designed in the 1990s, using disc cages. Made of carbon-fiber in the shape of a rectangle, they act as shock absorbers and restore curvature. Bone grafts were used to fuse the cages in place. Cadaver bone was initially used, but had high rates of rejection. As a solution, spine specialists began taking bone from patients hips, for solid and secure fusions, less complications, and improved flexibility.
3. Older Surgical Techniques
Traditional back surgery has been so invasive it can take months to recover. Patients sometimes report stiffness, paralysis, and being worse off than before the surgery.
Surgical techniques continue to be updated and improved for better outcomes. Along with more exact diagnostic information, there is new hope for Failed Back Surgery Syndrome.
4. Outdated Diagnostics
Many cases of Failed Back Surgery Syndrome are simply because doctors use recumbent (lying down) MRIs. When a patient lies down, it changes the pressure on the spine, sometimes leading to missed diagnoses.
Failed back surgery specialists realized the benefits of Upright MRI imagery, being able to scan patients in weight-bearing positions: sitting, standing, even bending. The technician can make incremental adjustments to each
position, and scan where the pain is greatest. This allows doctors to find abnormalities that recumbent MRIs sometimes miss.
5. Poor Bedside Manner
The worst part of Failed Back Surgery Syndrome is the emotional toll it takes on back pain sufferers. When doctors cannot find or fix the problem, they sometimes blame the patient. They may refuse a referral request to another specialist because they're offended.
Sometimes patients sense that their doctors are just guessing, because they don't exude confidence in their assessment or treatment. Doctors may sometimes turn down patients because they are afraid of the liability, leading to patients feeling hopelessness.
Hope comes from a confident spine doctor who says, “I won’t give up. I’ll find out what’s wrong.”