5 Ways to Minimize Failed Back Surgery and Continued Back Pain
November 5, 2009
by: Staff Writer
For any person who is considering back surgery to alleviate chronic pain, the question of “What if the surgery does not work” is likely to cross the mind at one point or another, possibly adding more stress to what is often already a difficult decision.
The term “failed back surgery syndrome” (also known as FBSS or failed back syndrome) is sometimes used to describe back surgeries that are not successful. Patients should be aware that this term is a misnomer rather than an actual syndrome acquired following surgery, and basically refers to situations in which patients continue to experience pain after surgery.
A back surgery may not achieve its desired results for various reasons that are out of the patient’s hands; with that said, there are some things that patients can do to minimize the chance of an unsuccessful surgery in which postoperative back pain is present.
Be Confident in Your Diagnosis
The number one reason that back surgeries are not effective is because of misdiagnosis of the probable cause of back pain, leading to operation on the wrong anatomical lesion. Prefacing this point, it’s important to know that spine surgery is only indicated when there is an identifiable anatomical lesion causing spinal instability or nerve pinching.
With this stated, assess your spine surgeon’s confidence in his or her diagnosis of the source of your back pain. Ask them about the specific anatomic lesion that would be addressed by the surgery, the alternatives to surgery, and what would happen if the condition is left untreated, and also question the surgeon on why he or she is recommending the specific surgery.
If the surgeon is unsure about the diagnosis, if you are not confident in the answers provided or if you would just be more comfortable, consider getting a second opinion. Visiting a different spine surgeon can allow the patient to get another perspective on radiographic findings and see what that surgeon would suggest for the situation.
Remember that if you are going to have surgery, you owe it to yourself to know that you’re doing it for the right reason. Understand how to get an accurate back pain diagnosis.
Trust Your Spine Surgeon
It goes without saying that your spine surgeon will play a major part in the success of your surgery. Regardless of whatever surgery is suggested, ask the surgeon about his or her experience performing the procedure. For example:
- How many of the recommended surgeries does this surgeon perform each year?
- How have other patients fared in the past following a similar surgery by this surgeon?
- Does the surgeon have any patients who have had the same surgery and would be willing to talk to you about their experiences?
- Who would be assisting with the surgery?
As you will be entrusting this person with your health during surgery, it’s important to be confident and comfortable with your spine surgeon. Consider these specific questions to ask your spine surgeon.
Know the Percentages
Patients should know that even with the best surgeon and indications, spine surgery is not 100% guaranteed to produce a successful result. In other words, a spine surgery can be performed for the right anatomical reason and done according to textbook, yet some pain may still exist following surgery.
To cover some of your bases in regards to this above point, know the success rates of the recommended surgery. For example:
- Certain surgeries like a discectomy or microdiscectomy for a lumbar herniated disc that is causing leg pain, and a spine fusion for spinal instability from spondylolisthesis are more predictable operations.
- On the other hand, surgeries like a discectomy for a herniated lumbar disc causing lower back pain or a spinal fusion for multi-level lumbar degenerative disc disease are far less likely to be successful.
Knowing the success/failure rates of specific back surgeries can provide patients with a better feel for the surgery, yet patients should not put full stock in these success rates as applied to their situations. For example, just because a surgery is successful 90% to 95% of the time doesn’t mean that it will automatically be so for you.
Learn more about what you can expect from spine surgery for lower back pain.
Be Ready to Rehabilitate
Back surgery is more than just the surgery, with rehabilitation playing an important role in making the surgery as beneficial as it can be. Probably the second most common reason that back surgeries do not succeed is because of inadequate or improper rehabilitation following the procedure.
With this in mind:
- Understand what your rehabilitation program will entail following surgery (how many hours per day/times per week, etc.)
- Speak to a physical therapist to learn more about your rehabilitation program and to get a projected schedule of what will be expected of you
- Honestly ask yourself if you will be dedicated and self-motivated to rehabbing to the best of your abilities after surgery.
Learn more about the importance of rehabilitation and exercise following spine surgery.
Set Realistic Expectations and Avoid Stress as Best as Possible
Easier said than done when it comes to having surgery, this point hits on the overall theme of doing your homework prior to surgery.
Ideally, the more prepared you are for surgery, the more prepared you’ll be for it afterward. Extensive research has demonstrated how the patient’s overall experience and ultimate outcome from back surgery can be improved with psychological preparation.
From having confidence in your decision to have surgery to making accommodations in your work and daily life for rehabilitation prior to surgery to even having your post-operation must-haves all in order before the operation, there are many ways in which you can minimize certain stressors and focus on what matters the most: achieving effective pain relief after surgery.
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