Spinal pathologies

Failed back surgery syndrome

Failed Back Surgery Syndrome (FBSS) is a complex condition characterized by the persistence, recurrence, or onset of lower back and/or radicular pain after one or more spinal surgical interventions.

This is one of the most complex causes of chronic spinal pain and can produce significant functional limitations, emotional distress, and a significant decline in the patient’s quality of life.

Pain may persist despite technically correct surgery due to multiple degenerative, neuropathic, inflammatory, and biomechanical mechanisms that require highly specialized and individualized assessment.

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What causes can produce an FBSS?

Failed back surgery syndrome is not usually due to a single cause, but to a combination of different structural and neurological factors.

Among the most frequent causes are:

Epidural fibrosis and periradicular adhesions
Persistence or recurrence of herniated disc
Foraminal or residual canal stenosis
Vertebral instability
Progressive disc degeneration
Residual facet joint pain
Vertebrogenic pain
Chronic nerve injury or sensitization
Post-surgical biomechanical alterations
Pseudoarthrosis or vertebral instrumentation failure

In many patients, complex neuropathic and musculoskeletal pain mechanisms coexist.

What are the most common symptoms?

Symptoms may vary depending on the structures involved and the type of previous surgery.

The most common symptoms include:

Persistent or recurring lower back pain
Lumbosciatica or chronic radicular pain
Neuropathic pain like a burning sensation or electric shock
Tingling or sensory disturbances
Muscle weakness
Significant functional limitation
Pain when walking, sitting, or standing
Lower back stiffness and muscle contracture

In certain patients, pain can become chronic and generate a significant physical and emotional impact.

Advanced diagnostics and precision medicine

Diagnosing FBSS requires a comprehensive and highly specialized evaluation aimed at accurately identifying the structures responsible for persistent pain.

Accurately identifying the source of the pain is essential to avoid unnecessary further surgeries and to select the most appropriate treatment.

Treatment of Failed Back Surgery Syndrome

Treatment should be individualized according to the causes of the pain and the clinical characteristics of each patient.

At VERTEBRA SpinePain & Regenerative SURGERY CENTERS we perform a comprehensive and multidisciplinary approach to FBSS using advanced spinal intervention techniques, neuromodulation and minimally invasive surgery.

Among the available therapeutic options, the following stand out:

Specialized pharmacological treatment for neuropathic pain
Physiotherapy and advanced functional rehabilitation
Image-guided infiltrative treatments in the epidural cavity
Selective root blocks
Epidural adhesiolysis and neuroplasty
Radiofrequency and neuromodulation
Regenerative Medicine
Minimally invasive spinal endoscopy
Spinal cord neurostimulation
Implantable intrathecal pumps in complex cases
Advanced techniques for surgical revision and spinal stabilization

Spinal cord neurostimulation is one of the most effective therapeutic options in selected patients with persistent neuropathic pain after spinal surgery.

At VERTEBRA SpinePain & Regenerative SURGERY CENTERS we have advanced experience in the diagnosis and interventional treatment specializing in complex lower back pain and failed back surgery syndrome, offering advanced and personalized treatments using techniques of maximum precision.

Our goal is to reduce pain, improve functionality, and restore the patient’s quality of life through a comprehensive and highly specialized approach.

VERTEBRA Clinic is a pioneer in the implementation and development of advanced minimally invasive techniques over the last four decades, having received international recognition.