Six Common Reasons For Back Pain After A Technically Successful Spine Surgery
Even under the best of indications and technical performance, spine surgery has its limitations.
Patients often do not understand that even in this day and age of modern medicine with all its advancements, spine surgery only maintains an overall success rate of 20-30% at 2 years.
Here are six common reasons for back pain after a technically successful surgery: 1) Scar tissue forms around the neural elements and causes pain.
If the scar tissue is removed with further surgery, guess what happens? Yes, more scar tissue will return, as the human body is very good at making it.
2) A spinal fusion was done with appropriately placed screws and rods along with bone fusion biological material, except the human body decided not to respond appropriately with a fusion.
When this happens, the hardware continues to absorb stresses and loads, and eventually can break with the patient experiencing increased pain.
Sometimes this may be fixed with more surgery, sometimes not.
3) When a neural element is freed up during surgery, or decompressed as it's called, typically it responds appropriately by healing along with pain going away.
However, there are times when the neural element has been compressed for so long that it decides not to respond with healing.
The pain may persist, and the answer when this happens is not further decompressive surgery unless there's still compression of a neural element.
4) The surgery performed only addressed part of the problem.
An example would be if an adult patient has significant pain from a large degenerative scoliosis spanning 12 spinal levels.
Rather than addressing all of the levels, the patient decides to only have 3 levels addressed.
This decision will decrease the risk for the patient, but at the same time increase the risk that continued pain will be the end result.
Rather than achieving 80% pain relief, maybe only 50% is achieved.
5) The indication for surgery was poorly chosen.
If a patient has straightforward degenerative disc disease at three lumbar levels with significant back pain, fusing all three levels has been shown to end up with a typically less than satisfactory result.
One or two levels is commonly performed.
6) The initial result was great, however, a problem arose at an adjacent level later on.
Every level of the spine absorbs stresses in a normal situation, however, if there has been a spinal fusion no stresses are absorbed.
So they either go up or down and the next level(s) in line may deteriorate.
Patients often do not understand that even in this day and age of modern medicine with all its advancements, spine surgery only maintains an overall success rate of 20-30% at 2 years.
Here are six common reasons for back pain after a technically successful surgery: 1) Scar tissue forms around the neural elements and causes pain.
If the scar tissue is removed with further surgery, guess what happens? Yes, more scar tissue will return, as the human body is very good at making it.
2) A spinal fusion was done with appropriately placed screws and rods along with bone fusion biological material, except the human body decided not to respond appropriately with a fusion.
When this happens, the hardware continues to absorb stresses and loads, and eventually can break with the patient experiencing increased pain.
Sometimes this may be fixed with more surgery, sometimes not.
3) When a neural element is freed up during surgery, or decompressed as it's called, typically it responds appropriately by healing along with pain going away.
However, there are times when the neural element has been compressed for so long that it decides not to respond with healing.
The pain may persist, and the answer when this happens is not further decompressive surgery unless there's still compression of a neural element.
4) The surgery performed only addressed part of the problem.
An example would be if an adult patient has significant pain from a large degenerative scoliosis spanning 12 spinal levels.
Rather than addressing all of the levels, the patient decides to only have 3 levels addressed.
This decision will decrease the risk for the patient, but at the same time increase the risk that continued pain will be the end result.
Rather than achieving 80% pain relief, maybe only 50% is achieved.
5) The indication for surgery was poorly chosen.
If a patient has straightforward degenerative disc disease at three lumbar levels with significant back pain, fusing all three levels has been shown to end up with a typically less than satisfactory result.
One or two levels is commonly performed.
6) The initial result was great, however, a problem arose at an adjacent level later on.
Every level of the spine absorbs stresses in a normal situation, however, if there has been a spinal fusion no stresses are absorbed.
So they either go up or down and the next level(s) in line may deteriorate.
Source...