What is revision spinal surgery?
Spinal surgery achieves its aims in over 50% of cases.
Revision spinal surgery refers to the need for a repeat surgery on your back because pain has persisted after the original surgery. Revision surgery is one of the treatments for failed back surgery syndrome.
When is revision surgery for failed back surgery syndrome considered?
Revision spinal surgery may be considered if you’ve developed complications after the first surgery or if surgery does not seem to have relieved your symptoms.
It can be very disheartening to have gone through one operation, realise that it hasn’t given you a new lease of life, and then be faced with another surgery. Understandably, you want to be sure that a second operation will deliver.
Why do some back surgeries fail?
The language of ‘failure’ is not helpful in this context. Discussions of failure tend to lead to a need to assign blame.
It is undeniably frustrating to need revision surgery. Surgeons always try to learn from these situations – but it rarely means anyone was to blame.
Spinal surgery may ‘fail’ because of:
Diagnostic of surgical errors or equipment breakdown
- Your condition was misdiagnosed so surgery did not help
- Your condition was correctly diagnosed but surgery wasn’t the right treatment for it
- Your surgeon made a mistake during the operation
- The screws, implants or other hardware used in your operation broke down.
Your overall health
- You’re a smoker (nicotine affects your body’s ability to heal bones)
- You have an underlying condition like diabetes, peripheral artery disease, depression or obesity which complicates your recovery.
Subsequent medical complications
- You developed a herniated disc
- Your vertebrate did not grow together after a spinal fusion
- Scar tissue formed in or around your spine
- You developed adjacent segment disease where parts of your spine near the site of your operation experience accelerated wear and tear
- You experienced common complications of surgery such as an infection.
Any surgery carries risks. The human body is complex and spinal surgery is a delicate endeavour. There can be no guarantee of success.
Pain also involves complicated processes. Sometimes, surgery has achieved its aims – no medical explanation can be found for your ongoing pain. Yet your pain is real. Your body may be amplifying pain messages due to your nervous system or psychosocial factors. Pain management techniques led by a psychologist or a pain clinic may help people with failed back surgery syndrome.
What is the treatment for failed back surgery syndrome?
If you’re in ongoing pain despite your back surgery, then we go back to the beginning.
- We review your case, examine you carefully, and order fresh tests and scans to identify the cause of your ongoing pain.
- This may be a new condition that’s developed since your surgery or a continuation of your original condition.
- This may be a new condition that’s developed since your surgery or a continuation of your original condition.
- Our multidisciplinary team develops a plan of conservative treatment options to help improve your mobility and ease your pain.
- Conservative treatments have fewer risks or side effects. If you’ve already had one unsuccessful surgery, you may be less likely to benefit from another one.
- Your treatment plan may include pain management for failed back surgery syndrome, psychological support, physiotherapy and occupational therapy.
- Revision surgery may be needed if:
- You’ve developed serious complications that need immediate attention – such as incontinence, numbness, tingling, weakness, increased spinal instability, a spinal infection or cauda equina syndrome.
- Conservative treatments don’t seem to be helping.
- Remember that revision surgery has diminishing returns. While over 50% of primary surgeries succeed, only 30% of second surgeries do, dropping to just a 5% success rate for fourth surgeries.
- Revision surgery is a big decision though – it’s worth getting a second opinion and asking detailed questions about the risks, benefits and alternatives and be clear about the goals of revision surgery so you can have realistic expectations. The goal may be decompression, stabilisation or both.
What is recovery like after spinal revision surgery?
Recovery will be similar to your experience after your first surgery. You will be discharged into a rehabilitation program with our allied health team who will help you to work on your strength, flexibility and ease of movement.
You can improve your chances of a good recovery by being as healthy as possible before the operation. Lose weight if you need to, stop smoking, ensure any underlying medical conditions are being treated appropriately.
How can the Victorian Orthopaedic Spine Service help?
We take failed back surgery syndrome seriously and want to help you find a way through it. Whether your original surgery was done here or elsewhere, we can review your history, identify the cause of your present pain, and recommend treatment options to help relieve some of your symptoms.
Please book a consultation today.
Disclaimer
All information is general in nature. Patients should consider their own personal circumstances and seek a second opinion. Any surgical or invasive procedure carries risks.
