UNDERSTANDING THE PROBLEM
Failed back surgery syndrome is a generalized term that is used to describe the condition of patients who have experienced unsuccessful results following spine surgery to treat neck or back pain. Specifically, the term applies when spine surgery has not alleviated the original problem or has created other, more significant problems, resulting in continuing or worsening pain.
The complexities of revision surgery are vast and selecting a specialist with relevant experience in "a specific revision" is imperative. AIMIS provides experts with unparalleled experience for your best treatment options and outcomes.
UNDERSTANDING WHO SUFFERS
It is estimated that up to 40 percent of patients who undergo traditional open back surgery experience failed back surgery syndrome. The incidence of failed back surgery syndrome, or FBSS, depends upon many factors. For instance, FBSS tends to occur more frequently in the lumbar (lower) region than in the cervical (upper) region of the spine. Additionally, the risk of developing FBSS is much higher following an open spinal fusion procedure than after undergoing a minimally invasive technique.
POTENTIAL SIGNS AND SYMPTOMS
If you have FBSS, you may experience or develop symptoms in varying degrees of severity, such as:
- Continued or chronic pain
- New spine conditions
- Pain above or below the treated level of the spine
- Limited mobility
- Inability to recuperate
- Dull, aching pain in the neck, back or legs
- Sharp or stabbing pain in the extremities
- Spinal joint immobility
- Dependence on prescription drugs
EXAMINATIONS USUALLY REQUIRED
Understanding the difference between standard postoperative soreness and FBSS can be difficult because there is almost always a little pain and discomfort following spine surgery. In addition, the rehabilitation and physical therapy required after surgery may aggravate the healing muscles and other tissue, causing some discomfort. While this type of soreness can be expected for the first few weeks following back surgery, a more intense, chronic pain or the development of new pain and symptoms may be signs of something more serious.
Therefore, it’s important that the physician provides a thorough examination, understands the medical history and uses some type of imagery (X-ray, MRI, CT scan) to pinpoint the source of the discomfort before suggesting a treatment strategy.
PROPOSING TREATMENT AND WHY AIMIS
Some patients who undergo traditional open back fusion surgery may develop a condition called failed back surgery syndrome. Failed back surgery syndrome is a term used to describe the continuation or worsening of symptoms following open spine surgery and who require potential revision surgery.
AIMIS minimally invasive surgery by leading expert is a safer and effective alternative to traditional open back surgery. The proposed treatment for you failed back surgery will be determined by examination and review of your imaging (MRI or CT etc) to show the source of your symptoms and pain.
Our minimally invasive stabilization surgery is performed through a small incision in the back. Through this incision, the surgeon will access the spine without disrupting any of the surrounding muscles and soft tissue. Once the spine is accessed, the diseased disc or vertebrae is removed to free the impacted nerve in the spinal canal that is causing the chronic pain. For patients with failed back surgery syndrome, the surgeon might remove the spinal fusion hardware that did not set properly and is causing your pain. Once the disc, vertebrae or failed fusion hardware is removed, the surgeon will insert an implant into the empty space in the spine to offer immediate stabilization.
We offer several minimally invasive procedures, including:
- Foraminotomy, - a procedure which decompresses the nerves that travel from the spinal cord through the intervertebral foramina. Foraminal narrowing and pinched nerves can occur as a result of a number of spinal anatomical abnormalities, including bone spurs, herniated discs, bulging discs, thickened ligaments and others.
- Laminotomy – a procedure which aims to relieve pressure that has been placed on the spinal cord because of spinal stenosis ( narrowing of the spinal canal). Spinal stenosis can have many causes, including bone spurs, bulging discs, herniated discs, spinal arthritis and thickened ligaments.
- Discectomy, a procedure which involves removing the portion of a herniated or bulging disc that has invaded the spinal canal and caused the compression of a nerve root or the spinal cord.
- Facet thermal ablation, which is performed to deaden one or more medial branch nerves that innervate the facet joints. It is commonly used to relieve the symptoms associated with spinal arthritis.
- AIMIS’s minimally invasive procedures are also sometimes used to treat the symptoms associated with sciatica, spondylolisthesis and other common spine conditions.
For a variety of cases there are a range of treatment options which AIMIS perform and include:
- Minimally Invasive Decompression Surgery
- Minimally Invasive Fusion Surgery,
- Minimally Invasive Stabilization Surgery Discectomy
- Artificial Disc Replacement Surgery,
- Total Disk Replacement (TDR),
- Anterior Cervical Discectomy & Fusion,
- Decompressor Discectomy,
- Lumbar Disc Microsurgery Treatment
- AxiaLIF or Axial Lumbar Interbody Fusion
- Stem cell transplantation – see page on Degenerative Disc Disease for more information
Why minimally invasive spine surgery?
Minimally invasive spine surgery was developed to treat spine problems with less injury to the muscles and other normal structures in the spine. It also assists the surgeon to see where the problem exists in the spine. Minimally invasive spine surgery (MISS), does not involve a long incision as is open surgery which helps to avoid damage to the muscles surrounding the spine. In most cases, this results in less pain after surgery and a significant faster recovery.
Spine surgery is normally recommended once a period of nonsurgical treatment likely including medications and physical therapy has not provided pain relief caused by the back problem. Surgery is considered when the source of your pain and underlying cause can be identified and surgical procedure proposed. Minimally invasive techniques today are common and being used for a wide range of spine procedures.
Benefits of minimal invasive spine surgery include:
- Small incisions
- Less pain. Often less pain than open procedures because less of the natural anatomy is disrupted
- Shorter Hospital stay
- Quicker return to daily activities
- Lower infection and complication rate
- Less blood loss. Smaller incisions also mean less blood loss, which can ultimately improve outcomes.
Minimally invasive procedures take a surgery that could be a dramatic event and makes it have less of an impact!
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REPUTABLE AND PRESTIGIOUS SURGEONS
AIMIS' skilled team of neurosurgeons, orthopaedic surgeons and ancillary professionals has one of the leading experiences in the world for minimally invasive spine surgery. Our full team are consulted with each case to find the most suitable experienced doctor for the patient’s exact issue, to ensure the maximum potential outcome of treatment
GETTING MORE INFORMATION BEFORE MOVING FORWARD
YOU MAY HAVE QUESTIONS LIKE:
- Can I get more information before I commit to this?
- Can I get a second opinion from you before I commit to this?
- How can I find out the cost before I have any obligation?
WHAT AIMIS CAN DO:
AIMIS will provide a full review, diagnosis and potential surgical options for your condition, after receiving the relevant examinations and information from you. They will also provide an estimate for your surgical procedure before you decide.
AIMIS’ mission is to the provision of “true” healthcare for those who require it. It provides world leading surgeons using state of the art procedures to optimize potential surgical outcomes, whilst taking care of all arrangements so as to allow concentration on recovery.
AIMIS provide competitive prices for state of the art procedures. We also work with a large range of Insurance companies where your policy allows you to have surgery abroad.
FURTHER INFORMATION ON THE PROBLEM:
There are two main types of back surgery performed: decompression and stabilization (fusion). Decompression surgeries have a shorter recovery time and lower risk of complication than open back fusion surgeries. In some cases, a fusion surgery does not end in the vertebrae successfully fusing to the implant inserted in the spine. This causes the spine to remain unstable and possibly more pain if the implant is impacting a nerve in the spinal canal.
FURTHER INFORMATION ON INCREASED RISK GROUPS
While failed back surgery syndrome does not always develop after spine surgery, there are certain factors that can increase the risk of developing this condition, such as:
- Failure to properly identify the condition(s). Surgeons who see a low volume of patients with degenerative spine conditions tend to be less experienced and specialized in diagnosing and treating these conditions. As a result, when determining the underlying cause of a patient’s neck or back discomfort, a relatively inexperienced surgeon might attempt to correlate a patient’s pain pattern with a specific area of degeneration in the spine. However, the process of making an accurate diagnosis is not always this straightforward. Additionally, other sources of pain, such as hip osteoarthritis, can produce symptoms that are very similar to, and therefore often incorrectly attributed to, degenerative spine conditions. Based on an improper diagnosis, a surgeon might perform surgery at the wrong level of the spine or otherwise improperly treat the condition, leading to FBSS.
- Failure to adequately decompress a nerve root or otherwise treat the condition(s). A technical error on the part of a treating surgeon, such as leaving behind a bone fragment or some herniated disc material that is pressing on a nerve root or the spinal cord, can result in pain that continues or worsens after surgery.
- Spinal fusion failure. The goal of a traditional spinal fusion procedure is to relieve nerve compression by removing a damaged disc and stabilizing the adjacent vertebrae with bone grafts or implants that are naturally fortified as the body heals after surgery. However, in order to successfully address neck or back pain through spinal fusion, a surgeon must first accurately identify the source of a patient’s pain. Furthermore, every patient heals at a different rate. Because vertebral fusion takes place as part of the healing process, it can take up to several months to achieve a solid fusion in some patients, while it never fully occurs in others.
- Implant migration. Sometimes, an implant can shift after being placed by a surgeon. This most often occurs during recovery, before the body’s healing process has progressed to the point that the implant has attached firmly to the vertebrae. An implant that has moved out of its intended spot will be less effective — or completely ineffective — at stabilizing the spine. Moreover, if a displaced implant compresses sensitive neural tissue, it could create a painful new spine condition.
- Scar tissue formation. As part of the natural healing process, the body forms bands of scar tissue following any form of tissue disturbance, such as spine surgery. These fibrous adhesions can potentially bind a nerve root, resulting in a condition called epidural fibrosis, which can lead to postoperative pain and FBSS.
- Nerve damage. Decompressing a nerve root through spine surgery will typically cause temporary inflammation and can lead to increased pain until the inflammation subsides. However, in rare cases, nerve damage can occur, resulting in symptoms like chronic pain and weakness in certain muscle groups.
FURTHER EXAMINATION THAT MAYBE REQUIRED OR REQUESTED
Most Tarlov cysts are discovered on MRI, CT or Myelogram. The best imaging study to image the Tarlov/perineural cyst is a "spine MRI", and since the vast majority (95%) of the perineural cysts are on the sacral spine, then the order should be for a "full sacral spine MRI (S1-S5) all the way to the coccyx/tailbone". Additionally, the ordering physician should request the radiologist to "look for the presence of Tarlov/perineural cysts, and if any are imaged, to report the cysts and their specific locations, sizes and numbers.
If the patient’s symptoms are related to the upper sections of the spine (although the cysts occur much less frequently in these areas (3-6%), then the appropriate cervical, thoracic or Lumbar MRI should be ordered. Some patients have the cysts in more than one section of the spine. It is sometimes confusing to make an accurate diagnosis as to the cause of the symptoms, if there are multiple diagnoses found, such as herniated discs, ruptured disc, DDD (degenerative disc disease). It is sometimes diagnostically conclusive that the cysts are the cause of symptoms, when pain is improved by aspirating the fluid from the cysts.
WHY AIMIS FOR THIS SURGERY
AIMIS strives for excellence in delivering the best surgical outcomes, via the extensive expertise of its prestige surgeons, its technologies, its highly trained staff and superior facilities to provide an individualized and compassionate experience in a comfortable environment. All patients are treated with the individual care they deserve in an effort to provide the best chance of successful treatment.
OTHER SERVICES PROVIDED BY AIMIS
In addition to its Innovative Healthcare, AIMIS provides seamless service along the way. From the start of your journey you'll know the best flights to take, where you'll be staying, what paperwork you will need. You will have a personal assistant assigned; from your pick up at the airport, to your accommodation, continuous assistance at your pre-consultation, through surgery and in your postsurgical care. Our Patients have said that they feel they have become "part of our family" and some even asked to stay a little longer! AIMIS is here to assist you in an all you requirements, allowing you to focus on your health and recovery.