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What is failed back surgery syndrome?

Reviewed by Dr. Nileshkumar Patel, M.D., M.B.A.

Failed back surgery syndrome (FBSS) occurs when a patient continues to experience pain or disability after back surgery. Symptoms may include chronic or recurring pain and disability in the back, leg, or other affected areas after the surgery.

FBSS is a complex condition and can be challenging to diagnose and treat. Diagnosis typically involves a thorough physical examination, medical history review, and diagnostic imaging tests such as MRI or CT scans.

What are the causes of FBSS?

Pain can take a toll not only physically, but mentally as well. To help with this, you can suggest doing some low-impact activities with your loved one. Physically demanding activities can be an option as well but should be introduced slowly, to avoid exacerbation of their symptoms or triggering flare-ups. A few suggestions for low-impact activities include:

  • Excessive bleeding during surgery

  • Infection leading to inflammation and chronic pain

  • Damage to the spinal cord nerves or surrounding tissues 

What are the treatment options for FBSS?

Treatment options for FBSS can vary based on a number of factors, including the patient’s symptoms and the severity of the condition. Patients should work closely with their healthcare providers to determine the most effective treatment approach for their particular circumstances and needs.

Common treatments may include:

Conservative treatments

  • Physical therapy
  • Chiropractic care
  • Acupuncture

Medications

  • Non-steroidal anti-inflammatory drugs (NSAIDs) such as Naproxen and Ibuprofen
  • Epidural steroid injections
  • Opioids
  • Antidepressants
  • Anticonvulsant medication

Surgical procedures

  • Repeat back surgery
  • Corrective back surgery

Pain Management

  • Spinal cord stimulation
  • Nerve decompression
  • Spinal fusion

Recent studies have revealed the limited success conservative care provides for FBSS patients.1,2,3 Prescription medications are not suitable for long-term pain management. The Center for Disease Control (CDC) 2022 Opioid Guidelines recommend non-opioid therapies to help manage chronic pain, lasting over three months.4

With Boston Scientific’s clinically proven SCS therapy, patients can receive personalised, lasting relief.5,6

For individuals suffering from FBSS, Boston Scientific’s Spinal Cord Stimulation (SCS) therapy may be a suitable option to significantly reduce their pain, increase their functional abilities, and improve their quality of life.6

Boston Scientific’s SCS therapy is:

  • Drug-free
  • Included in the ARTG
  • Clinically proven to provide long-term relief from chronic pain on suitable patients7
  • Has a robust safety profile

Implanting an SCS System is a minimally invasive, reversible procedure. Patients have the added advantage of being able to see if SCS works for them before undergoing the implant procedure. An external trial system allows them to try SCS out for a few days too, so patients can see if SCS works for them before undergoing the implant procedure.

Boston Scientific SCS patients receive personalised pain relief with the WaveWriter Alpha™ Spinal Cord Stimulator (SCS) System. The device is designed to allow for precise pain targeting with sophisticated programming options. With the WaveWriter Alpha SCS System, targeted stimulation is tailored to meet each patient’s unique needs, resulting in increased pain relief and improved quality of life.*5

Get back to everyday activities

Effectively managing your pain could help you enjoy many things you’ve been missing. In a clinical study, patients using the Boston Scientific SCS therapy offered in the WaveWriter Alpha SCS System reported great improvement in their daily activities.5

See if Boston Scientific's pain management therapies are suitable for you

If you have a question or want to talk to a Boston Scientific Technical Representative, reach out to us directly. Take this quick quiz and find out.

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*As measured by the Oswestry Disability Index.

Reference: 

  1. Desai MJ, Nava A, Rigoard P, Shah B, Taylor RS. Optimal medical, rehabilitation and behavioral management in the setting of failed back surgery syndrome. Neurochirurgie. 2015 Mar;61 Suppl 1:S66-76 
  2. Amirdelfan K, Webster L, Poree L, Sukul V, McRoberts P. Treatment Options for Failed Back Surgery Syndrome Patients With Refractory Chronic Pain: An Evidence Based Approach. Spine (Phila Pa 1976). 2017,15;42 Suppl 14:S41-S52 
  3. Klessinger S. Radiofrequency Neurotomy for the Treatment of Therapy-resistant Neck Pain after Ventral Cervical Operations. Pain Medicine 2010:11, 1504-1510 
  4. Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022. MMWR Recomm Rep 2022;71(No. RR-3):1–95. DOI: http://dx.doi.org/10.15585/mmwr.rr7103a1 
  5. Wallace MS, North JM, Phillips GM, Calodney AK, Scowcroft JA, Popat-Lewis BU, Lee JM, Washabaugh EP 3rd, Paez J, Bolash RB, Noles J, Atallah J, Shah B, Ahadian FM, Trainor DM, Chen L, Jain R. Combination therapy with simultaneous delivery of spinal cord stimulation modalities: COMBO randomized controlled trial. Pain Manag. 2023 Mar 3. doi: 10.2217/pmt-2022-0101. Epub ahead of print. PMID: 36866658. (N=59 at 24 months post implant). 
  6. Veizi, Elias, et al. Spinal Cord Stimulation (SCS) with Anatomically Guided (3D) Neural Targeting Shows Superior Chronic Axial Low Back Pain Relief Compared to Traditional SCS --LUMINA Study, Pain Medicine, Volume 18, Issue 8, 1 August 2017, Pages 1534 -1548. (N=426)
  7. Thomson SJ, Kruglov D, Duarte RV. A spinal cord stimulation service review from a single centre using a single manufacturer over a 7.5 year follow-up period. Neuromodulation. 2017;20(6):589-599. N=321

Disclaimer and endnotes: 

Results from case studies are not necessarily predictive of results in other cases. Results in other cases may vary.

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Individual symptoms, situations, circumstances and results may vary. This quiz is meant for information purposes only, it is not intended to be used for medical diagnosis or treatment or as a substitute for professional medical advice. Please consult your doctor or qualified healthcare provider regarding your condition and appropriate medical treatment. This site is intended for Australian residents only. Please review the Boston Scientific Privacy Policy, for practices on the collection, storage, use and disclosure of your personal information.

Content of videos are for Information Purposes only and does not constitute medical advice. BSC strongly recommends that you consult with your physician on all matters pertaining to your health or to address any questions.

Talk to your healthcare professional about whether this product may be suitable for you as part of your overall plan to manage chronic pain. The WaveWriter Alpha System is not a first-line treatment for chronic intractable pain.

Surgery is required in order to use the WaveWriter Alpha System and any surgical procedure carries risk. Outcomes may vary for each patient. Patients should consult their healthcare professional about factors that could impact their response.

CAUTION: This product is not available for purchase by the general public. Indications, contraindications, warnings, and instructions for use can be found in the product labelling supplied with each device or at www.IFU-BSCI.com.

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