Failed Back Surgery Syndrome Treatment

Medically reviewed by Joshua L. Hare, DO, Founder & Medical Director

When pain continues after spine surgery

Failed back surgery syndrome, also called post-laminectomy syndrome, describes back or leg pain that persists or returns after spine surgery.[1] The surgery itself may have been technically successful: pain can continue because of scar tissue around a nerve root, arthritis in the joints beside a fusion, a level the operation did not address, or the sacroiliac joint below it. At IPC, evaluation starts with your operative history and imaging, then uses diagnostic image-guided injections to work out which structure is generating the pain now. Treatment options include targeted injections and, for nerve pain that has not responded to other measures, spinal cord stimulation or an intrathecal pain pump.

Symptoms of failed back surgery syndrome

The name is misleading: it does not mean the operation was done badly. It means the pain has another explanation that still needs finding.

• Back pain that never fully settled after the recovery period, or that improved and then returned months later
• Leg pain, numbness or tingling — either the same symptoms as before surgery, or a new pattern in a different part of the leg
• Pain with a different character than before the operation, often more burning or electric
• Reduced tolerance for standing, walking or sitting through a workday
• Sleep repeatedly interrupted by back or leg pain

Whether the pain never improved, or improved and then came back, is genuinely useful history — the two patterns point toward different causes. It is worth writing down the timeline before an appointment.

When to see a pain specialist about failed back surgery syndrome

If pain has persisted for months after spine surgery, a pain specialist's job is to work out which structure is generating it now. The candidates — scar tissue, arthritis in the neighboring joints, a level that was not part of the operation, the SI joint — look similar from the outside and are treated differently, which is why diagnostic image-guided injections are often the first step: they identify the source before anything longer-term is considered.

Being assessed does not commit you to another procedure.

New fever, wound drainage, or rapidly worsening weakness soon after spine surgery needs same-day contact with your surgical team. New loss of bladder or bowel control, numbness in the saddle area, or weakness in both legs needs same-day emergency assessment.

Treatment options for failed back surgery syndrome

The right option depends on what the diagnostic work-up identifies. Several of the options below begin with a trial phase, so you and your physician can judge the benefit before committing to anything permanent.

References

Clinical sources for this page.

1. Failed Back Surgery Syndrome. StatPearls [Internet], National Library of Medicine; updated May 1, 2023. Back to first citation ↑