Failed Back and Failed Fusion Syndrome

After any spine surgery, a percentage of patients may still experience pain. This is called failed back or failed fusion syndrome, which is characterized by intractable pain and an inability to return to normal activities. Surgery may be able to fix the condition but not eliminate the pain.

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Symptoms

The main symptom is pain following back surgery. Additionally, the patient's ability to complete activities of daily living may be altered.

 

Causes and Risk Factors

In addition to smoking, the most common causes are:

  • Formation of scar tissue
  • Recurring or persistent disc disease at adjacent levels
  • Continued pressure from spinal stenosis
  • Instability or abnormal movement
  • Pseudoarthrosis or failure of the fusion
  • Nerve damage within the nerve, arachnoiditis
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Diagnosis

A diagnosis will be based on the patient's symptoms and medical history.

Additional tests that may be useful include:

  • Magnetic resonance imaging (MRI)
  • Computed tomography (CT scans)
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Treatments

Treatment of these conditions once they have occurred will vary depending on the nature of the condition and what caused prior surgery to fail.

Some patients fail to improve even after the best surgical intervention. In spite of careful diagnosis and a successful operation, patients may continue to experience pain or limitations in performing daily activities. This continuation of symptoms is known as "failed back syndrome." A spinal fusion occurs after the surgeon creates the conditions for the bones of the spine to unite into an immobile block. The union of the fusion mass occurs over time. When the time for healing is extended or the fusion fails to unite, this is a called a "failed fusion" or pseudoarthrosis.

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