Understanding and Managing Failed Neck or Back Surgery

At Horizon Spine & Pain of Utah, we understand how frustrating it can be to undergo spinal surgery and still experience pain afterward. Failed Back Surgery Syndrome (FBSS), also known as Failed Neck Surgery Syndrome when it affects the cervical spine, is a complex condition that requires specialized evaluation and treatment. Our team is dedicated to helping you find real relief — even after previous surgeries.

Failed back or neck surgery refers to persistent or recurrent pain following spinal surgery, typically lasting longer than three to six months post-operation. Despite technically "successful" procedures, patients may still experience chronic pain, nerve symptoms, or limited mobility due to various factors.

FBSS is not a single problem but rather a set of conditions that can develop after spine surgery.

Several issues can contribute to ongoing pain after spine surgery:

• Residual or recurrent disc herniation
• Scar tissue formation (epidural fibrosis) irritating nerve roots
• Spinal instability or adjacent segment degeneration
• Inadequate decompression of nerves during surgery
• Hardware failure or implant-related complications
• Nerve damage that occurred before or during surgery

Sometimes, pain arises from issues unrelated to the original surgical site, highlighting the importance of an accurate diagnosis.

Certain factors increase the risk of failed spine surgery outcomes:

• Multiple spinal surgeries
• Severe or long-standing nerve compression prior to surgery
• Complex conditions like scoliosis or spinal deformities
• Diabetes or other health conditions that slow healing
• Smoking, which impairs bone fusion and wound healing

Understanding these risks helps in planning both surgery and postoperative care more effectively.

Signs of failed neck or back surgery may include:

• Persistent or recurrent back or neck pain
• Radiating pain into arms, legs, or buttocks
• Numbness, tingling, or weakness
• Difficulty walking or standing for prolonged periods
• Muscle spasms or stiffness
• New areas of pain developing after surgery

Pain may be similar to pre-surgical pain or may present differently if new nerve areas are involved.

At Horizon Spine & Pain of Utah, we follow a thorough, individualized diagnostic process:

• Comprehensive review of surgical history and current symptoms
• Physical and neurological examinations
• Imaging studies:
  • MRI or CT scans to assess surgical sites, scar tissue, disc status, or hardware positioning
  • X-rays to evaluate spinal alignment and hardware integrity
• Electrodiagnostic testing (EMG/NCS) to detect ongoing nerve issues

Precise diagnosis is critical to guiding effective treatment strategies.

Many patients with FBSS respond well to non-surgical management, such as:

Medications:

• Anti-inflammatory drugs (NSAIDs)
• Neuropathic pain medications (gabapentin, pregabalin)
• Muscle relaxants

Physical therapy:

• Core strengthening, posture training, and mobility exercises

Cognitive Behavioral Therapy (CBT):

• Managing the emotional impact of chronic pain

Lifestyle adjustments:

• Weight management, ergonomic changes, and smoking cessation

Our goal is to optimize function and minimize pain without immediate additional surgery.

When needed, we offer advanced interventional treatments, including:

• Epidural steroid injections:
  • Target inflammation around nerves compressed by scar tissue
• Nerve root blocks:
  • For pinpoint nerve pain relief
• Facet joint injections:
  • Addressing pain originating from spinal joints
• Spinal cord stimulation (SCS):
  • Implantable devices that deliver electrical signals to disrupt pain transmission and improve function

Spinal cord stimulation is particularly effective for many FBSS patients who have failed multiple conservative treatments.

Surgery may be considered again if:

• There is clear evidence of structural problems like hardware failure or severe instability
• Severe, progressive neurological deficits (such as weakness or loss of bowel/bladder control) are present

Possible surgical options include:

• Revision decompression surgery
• Hardware removal or adjustment
• Spinal fusion surgery (if instability is causing pain)

Revision spine surgery carries higher risks than the first surgery, so careful planning and clear expectations are essential.

Patients trust Horizon Spine & Pain of Utah because we offer:

• Board-certified pain and spine specialists
• Personalized, conservative-first treatment plans
• Access to the latest minimally invasive therapies
• Expertise in diagnosing complex post-surgical pain conditions
• Comprehensive, compassionate care, focusing on your long-term success

Our mission is to help you regain control over your life, even after challenging spine surgery experiences.