Failed back surgery syndrome (FBSS) describes back or leg pain that continues, returns, or develops after spine surgery, even when the procedure itself was technically successful. It does not mean nothing more can be done. A careful re-evaluation can often identify why the pain persists and point toward effective treatment.
Treatment is matched to the cause found on re-evaluation, starting with the least invasive option that can help.
Pain management and rehabilitation
Advanced and surgical options
Second opinions are welcome. Your specialist will explain what the evaluation found and which options fit your situation.
Persistent pain after spine surgery usually has an identifiable reason. Common causes include:
Incomplete decompression
Pressure on a nerve was not fully relieved, or narrowing has returned.
Recurrent disc herniation
The same disc herniates again, or another disc is damaged; see herniated discs.
Scar tissue (epidural fibrosis)
Scar tissue forms around a nerve and irritates or tethers it.
Spinal instability
Excessive motion at an operated or neighboring segment.
Adjacent segment stress
A level next to a fusion takes on extra load and wears faster.
A different original source
The original pain came from a structure that was not the one treated.
A structured re-evaluation helps separate problems that can be corrected from pain that is better managed in other ways.
Review the history
Details of the prior surgery, how symptoms changed afterward, and treatments already tried.
Examine and image
A neurologic examination plus updated MRI or CT to look for recurrent compression, scar tissue, or instability.
Confirm the pain source
Diagnostic injections or nerve blocks can show which structure is generating the pain.
Match the treatment
From therapy and injections to spinal cord stimulation or revision surgery, the plan follows the cause.
No. The term describes pain that continues or returns after spine surgery. Many patients have meaningful options once the cause is identified, ranging from targeted injections to spinal cord stimulation to revision surgery.
Common reasons include incomplete decompression, a recurrent disc herniation, scar tissue around a nerve (epidural fibrosis), instability or extra stress at a neighboring level, irritation from hardware, or an original pain source that was not the one treated.
Sometimes. Revision surgery can help when there is a clear structural problem to correct. When the main issue is chronic nerve pain rather than a correctable structure, spinal cord stimulation may be a better option.
A second opinion is reasonable and welcome when pain continues after surgery. A fresh evaluation with updated imaging can reveal options that were not considered before.
A spinal cord stimulator delivers mild electrical signals to the spinal cord that interrupt pain signals before they reach the brain. A temporary trial lets patients test the therapy before a permanent device is considered.
Epidural fibrosis is scar tissue that forms around the nerves after spine surgery. It is a normal part of healing, but in some patients it can tether or irritate a nerve and contribute to ongoing leg pain.
Some discomfort is expected while tissues heal. Pain that continues beyond the expected recovery period, worsens, or returns after an initial improvement should be re-evaluated.
A review of the prior surgery and current symptoms, a physical and neurologic examination, and updated imaging such as MRI or CT. Total Spine and Orthopedics offers a complimentary MRI review; call (321) 499-4646 to schedule.
Symptoms vary with the underlying cause. Common signs include:
Hear our patients share their experience with us, All in their own words.
Expert, ultra-minimally invasive spine and orthopedic care, close to home.
Ultra-minimally invasive and endoscopic techniques
We specialize in procedures performed through incisions smaller than a dime, sparing muscle and supporting a faster recovery.
Same-day, outpatient procedures
Most patients walk in and return home within hours, rather than facing an overnight hospital stay.
Board-certified, fellowship-trained surgeons
Our team includes early leaders in endoscopic spine surgery.
A complimentary MRI review
Understand your diagnosis and options from a board-certified specialist before committing to any treatment.
Trusted by our community
More than 1,100 patient reviews at a 4.6-star average, and over 50,000 patients treated.
A careful, fresh look
We start by finding why the pain continues, and we welcome second opinions after surgery elsewhere.
Comprehensive spine and orthopedic care
From injections to advanced procedures, your full continuum of care is handled in one place.
Convenient locations across the Space Coast and Orlando
Care close to home in Melbourne, Orlando (Lake Nona), and Titusville.
