Failed Back Surgery and Nerve Root Blocks: Renowned Surgeon Dr. Kaixuan Liu Explains Causes for Failed Spine Surgery and Tips for Understanding Solutions
Failed back surgery isn’t simple to explain. You can blame it on the complexity of the task—the spine, after all, comprises a jumble of bony vertebrae and joints, shock-absorbing discs and nerve bundles and is utterly essential for normal functioning.
West Orange, NJ (PRWEB) July 31, 2013
Failed back surgery isn't simple to explain. You can blame it on the complexity of the task—the spine, after all, comprises a jumble of bony vertebrae and joints, shock-absorbing discs and nerve bundles and is utterly essential for normal functioning. Or you can blame it on the numbers: The U.S. has roughly twice as many back surgeries as any other developed nation, more than 1.2 million operations every year, and Americans’ annual spending for spinal care has nearly doubled in the last decade. But no matter how complicated or common it is, traditional “open” spine surgery is notoriously unreliable. In fact, statistics show that as many as 50 percent of these operations are unsuccessful: They result in continued (or even increased) pain, a condition known as failed back surgery syndrome, or FBSS.
Back surgeries can fail—and symptoms of FBSS can develop—for a few reasons, says Kaixuan Liu, MD, PhD, chief surgeon at Atlantic Spine Center. “We know that many cases of FBSS are the result of misdiagnosis,” Dr. Liu says. “Spinal surgery is designed to correct an anatomical problem—a damaged disc, perhaps, or an arthritic joint—that appears to be causing the patient’s pain. Misdiagnosing the problem means that the pain will probably remain, even if the problem was corrected—because that problem wasn’t the source of the pain.”
Despite the very real danger of failed back surgery syndrome, traditional spine surgery is performed fairly frequently for patients with chronic back and neck pain, Dr. Liu continues. The most popular operations include spinal decompression and spinal fusions using cages, bone grafts, bars and screws, he says. Many other cases of FBSS are the result of a failed laminectomy (surgical removal of the lamina, a section of bone on the back edge of each vertebra). If those operations aren’t successful, the patient can be left in far worse shape than before the surgery, with more severe pain and, even worse, scarring and nerve compression that was actually created by the surgery.
Tips for Understanding Solutions for FBSS
Of course, Dr. Liu says, the only way to truly avoid failed back surgery syndrome is to avoid surgery altogether, which obviously won’t be an easy choice if you’re in serious pain and have been told that surgery is your only option. In that case, Dr. Liu says, patients are advised to consider less invasive surgical options, such as endoscopic spine surgery, which has much better success rates (and lower incidence of complications) that traditional open surgery. In fact, endoscopic surgery is sometimes recommended in severe cases of FBSS. “Most experts would agree that having another open surgery to correct your initial open surgery is a bad idea,” Dr. Liu says. “The rates of success for subsequent open surgeries just get worse and worse.” But minimally invasive surgery can be the answer to some cases of FBSS.
Before considering any type of additional surgery, however, Dr. Liu recommends conservative treatments such as physical therapy. Another option is a nerve root block, which is an injection of a steroid medication and local anesthetic into the nerve root, which is the spot where the nerve exits the spinal column. These injections can be quite effective in relieving the pain of FBSS. In addition, they can be used as a diagnostic tool to help the doctor pinpoint the source of the patient’s pain and decide if further surgery is warranted.
About Dr. Liu: Kaixuan Liu, M.D., Ph.D., is a renowned endoscopic spine surgeon and founder of Atlantic Spine Center in West Orange, New Jersey (http://www.atlanticspinecenter.com). Dr. Liu is certified by The American Board of Pain Medicine and The American Board of Anesthesiology, and is a member of The International Society for Advancement of Spine Surgery, The American Society of Interventional Pain Physicians (ASIPP), The American Academy of Pain Medicine (AAPM), The International Intradiscal Therapy Society (IITS), and The American Society of Anesthesiologists (ASA). He also serves as an international surgeon for The Spinal Foundations in England.
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