What Is Failed Back Surgery Syndrome?
A la hora de identificar los tipos de dolor, se distinguen dos: el dolor agudo y el dolor crónico. El dolor agudo aparece rápidamente y puede ser intenso, pero dura relativamente poco. Suele aparecer tras una lesión o traumatismo y desaparece por sí solo.
A diferencia del dolor agudo, el dolor crónico es un dolor que dura mucho tiempo y no parece mejorar ni desaparecer. Este periodo de tiempo puede variar, pero generalmente abarca de tres a seis meses tras el inicio de los síntomas. El dolor crónico suele ser un síntoma debilitante de muchas enfermedades y se considera una enfermedad en sí misma cuando persiste más allá de la recuperación de una lesión o afección. El dolor crónico es un componente frecuente de muchos trastornos neurológicos.
El dolor le advierte de que algo no está del todo bien en su cuerpo y puede obligarle a hacer determinadas acciones y evitar otras. El dolor puede mermar significativamente su calidad de vida y afectar negativamente a su bienestar físico y emocional, alterando las relaciones con familiares, compañeros de trabajo y amigos, y limitando su movilidad y participación en las actividades cotidianas.
Cientos de síndromes o trastornos dolorosos conforman el espectro del dolor. Una causa de dolor es el síndrome de cirugía de espalda fallida (SFFE). El SFFE es un dolor lumbar que persiste a pesar de los procedimientos quirúrgicos o que aparece después de una cirugía para el dolor de columna en una zona cercana de la espalda. Ocurre cuando la cirugía no logra tratar el dolor lumbar del paciente.
Types of Failed Back Surgery Syndrome
Pain types associated with failed back surgery syndrome (FBSS) include persistent, dull and aching pain that involves either the back or legs or both, not associated with the healing process. This pain results from an unsuccessful back surgery that did not repair damage.
Causes of Failed Back Surgery Syndrome
Failed back surgery syndrome (FBSS) may be caused by either pre- or postoperative risk factors. Preoperative contributors may include smoking, obesity or psychiatric disorders (such as depression or anxiety). Postoperative contributing factors may include progression of degenerative changes (new or recurrent disc herniation), or muscular hypertrophy, atrophy and spasms.
Risk Factors for Failed Back Surgery Syndrome
Risk factors for FBSS include a poorly preoperative diagnosed patient for surgery. Some lesions respond better to surgery than others, primarily patients with anatomic lesions in the spine. Other risk factors include age, hypertension, preoperative pain, symptom location and postoperative rehabilitation success.
Screening for and Preventing Failed Back Surgery Syndrome
Like most spinal disorders, FBSS can be diagnosed using imaging scans such as X-rays, computed tomography (CT) and magnetic resonance imaging (MRIs). The type of scan depends on the original preoperative diagnosis requiring the surgery.
Signs and Symptoms of Failed Back Surgery Syndrome
Symptoms of FBSS typically involve exacerbated preexisting symptoms or new symptoms. They might include one or more of the following:
- Postoperative back spasms, stabbing pain or radiating pain
- New pain at a new level of intensity or from a new location
- Restricted mobility
- Ansiedad y depresión
- Inability to recuperate and/or dependence on pain medication
- Insomnio
Diagnosing Failed Back Surgery Syndrome
Failed back surgery syndrome (FBSS) is defined as lumbar spinal pain of unknown origin persisting despite surgical intervention or appearing after surgery for spinal pain originally in the same topographical location.
Treating Failed Back Surgery Syndrome
Treatment of FBSS may include medication, physical therapy or a follow-up surgical procedure. Failing success of medication and/or physical therapy, non-surgical treatments may include:
- Racz catheter procedure, also known as an epidural neurolysis, wherein the doctor injects an enzyme into the area to be treated to soften the scar tissue, thereby reducing inflammation which may be causing pain
- Radiofrequency ablation, which destroys the nerves around the spine that are sending pain impulses to the brain
- Facet joint injections to reduce inflammation in the joints.
- Nerve stimulation devices using electrodes to manage chronic pain
Living with Failed Back Surgery Syndrome
Living with FBSS means pain management using a range of solutions from prescribed pain medication, physical therapy or a follow-up medical procedure. Work with your physician to obtain a diagnosis and the best treatment program to ease your pain or to plan corrective procedures.