Chronic Neck Pain, Back Pain, Sciatica, and Failed Back Surgery Syndrome
In order to properly understand failed back surgery syndrome, we must first define it. Unfortunately, failed back surgery syndrome is something of a misnomer. In fact, FBBS is no more a syndrome than degenerative disc disease is a disease, and yet, they both contribute to neck pain, back pain, and sciatica. FBBS is actually an expression of chronic neck pain, back pain, and/or sciatica after one or more surgeries.
The etiology of chronic back pain associated with FBBS is usually attributed to one or more failed spine surgeries, along with a myriad of other contributing factors. The failure of the surgery, combined with an array of physical, psychological, cultural, and even socio-economic factors, results in what is commonly referred to as failed back surgery syndrome.
Failed back surgery syndrome is one of the most perplexing, and costly issues facing orthopedic medicine generally, and orthopedic surgeons specifically. The cost of FBBS is not only a reality in terms of the human cost, it has trememdous social and economic costs, as well.
Particularly problematic is the fact that the spine is an incredibly complex structure and there are as many reasons why people have neck and back surgery as there are reasons why that surgery fails. Researchers have generally divided back pain sufferers who have undergone surgery into one of two groups.
In the first instance, the first group, the neck pain, back pain, and/or sciatica sufferer underwent surgery that was never really called for or, if it was called for, a positive outcome was doubtful from the start. Or, the patients had surgery, it was necessary, but the outcome was less than desirable. Interestingly, individuals with a sciatic nerve pain complaint, sciatica, were more likely to achieve a positive outcome. However, individuals complaining of the more general “back pain” did not.
The remaining group of neck pain, back pain, and sciatica patients underwent operations that were inadequate and/or incomplete. Patients in this category, particularly those affected by a bulging or herniated disc, often had other pathologies, such as stenoses, that were overlooked, missed or even ignored.
Failure in most of the medical literature to address things like patients returning to work and to a productive lifestyle, make it difficult to quantify with any confidence the long term success of most back surgeries. However, the data suggests that the overall outcome is not good, particularly when the area causing the pain cannot be clearly identified or when more than one level of the spine is affected, as in the case of an individual presenting with chronic and/or acute neck pain, back pain, and sciatica; and, showing signs of advanced degenerative disc disease.
Failed back surgery syndrome is a major problem for patient and surgeon, alike. Not only are there issues associated with continuing neck pain, back pain, and/or sciatica but there are social, cultural and financial considerations as well.
In the next two articles we will explore in depth some of these factors and why an individual should do everything possible to avoid spine surgery if at all possible. The best strategy for neck pain, back pain, and sciatica treatment and relief is not back surgery, in fact it should be the last alternative, one that should be avoided if at all possible. Failed back surgery syndrome is one of the most complex and least understood issues facing orthopedic medicine, we will discuss the reasons for this next.
John
Professor John P. J. Zajaros, Sr., The Bad Back Guy
216-712-6526
Skype: johnzajaros1
johnz@ultimatebadbackstrategies.com
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