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YOU are here : Home > Spinecare Topics > Options for Spine Treatments > Benefits and Risks of Back Surgery
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Options for Spine Treatments
Benefits and Risks of Back Surgery
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Benefits and Risks of Back Surgery
There are numerous causes for FBS that include incomplete decompression, recurrent or residual disc herniation, formation of scar tissue and arachnoiditis. The course of post-operative pain requires comprehensive re-evaluation. This should include a thorough history and physical examination. Some cases will require more advanced studies such as nerve and muscle studies (electrodiagnostic evaluation) and advanced diagnostic imaging studies such as CT, CT/myelography or MRI. Post-operative MRIs are typically performed with and without a contrast agent to help identify the presence of scar tissue (fibrosis). The use of contrast agents also helps differentiate residual or recurrent disc herniation versus scar tissue formation. Re-evaluation after failed back syndrome is often performed by a spine surgeon or a neurologist who has special experience and interest in this condition. It is often necessary to obtain a second or third opinion, as the condition can often be quite complex.
Scar Tissue
Spinal surgery results in the development of some scar tissue (fibrosis). The degree and location of scar determines the level of significance. Scar tissue changes in size and consistency during the healing process. It usually shrinks in size with time. Scar tissue can occur within many different regions of the spine. It can occur around the spinal (facet) joints, within muscles, around spinal nerves, within spinal nerves, within the special linings (dura) as well as in the epidural space of the spinal canal. The most common location for scar tissue to develop after spine surgery is within the space surrounding the spinal nerves and spinal cord, the epidural space. There is a greater risk for excessive scar formation during open surgical procedures and minimally invasive procedures that lead to bleeding.
Scar tissue can develop at a spinal surgical site secondary to infection, ischemia, bleeding, thrombosis, and/or as the result of local immune reaction secondary to placement of surgical sponges and glove powder. Other contributing factors include recurrent disc herniation, lateral or central spinal stenosis, arachnoiditis, and epidural fibrosis. A spinal nerve root, which is adhered/trapped by scar tissue, becomes more exposed to compression injury secondary a disc bulge, disc herniation or bone spur because it is fixed in place and unable to move out of the way.
Open surgical procedures which are most likely to result in significant scar formation, include spinal fusion, laminectomy, and microdiscectomy. Some degree of scar tissue develops after each surgical procedure, but it contributes to persistent or new symptomatology in a small percentage of cases
Scar tissue may be associated with intractable pain due to its capacity to limit tissue movement and promote chronic inflammation. Scar tissue (fibrosis) can adhere to or wrap around a spinal nerve. It can create adhesive or restrictive bands between adjacent spinal structures. Scar tissue tends to have a good blood supply therefore when it is physically stretched it tends to bleed easily. The presence of recurrent microinjury and resultant bleeding promotes further scar tissue development (fibroproliferation). Epidural scar (fibrosis) can develop within 2-12 weeks of surgical intervention.
Scar Tissue
Spinal surgery results in the development of some scar tissue (fibrosis). The degree and location of scar determines the level of significance. Scar tissue changes in size and consistency during the healing process. It usually shrinks in size with time. Scar tissue can occur within many different regions of the spine. It can occur around the spinal (facet) joints, within muscles, around spinal nerves, within spinal nerves, within the special linings (dura) as well as in the epidural space of the spinal canal. The most common location for scar tissue to develop after spine surgery is within the space surrounding the spinal nerves and spinal cord, the epidural space. There is a greater risk for excessive scar formation during open surgical procedures and minimally invasive procedures that lead to bleeding.
Scar tissue can develop at a spinal surgical site secondary to infection, ischemia, bleeding, thrombosis, and/or as the result of local immune reaction secondary to placement of surgical sponges and glove powder. Other contributing factors include recurrent disc herniation, lateral or central spinal stenosis, arachnoiditis, and epidural fibrosis. A spinal nerve root, which is adhered/trapped by scar tissue, becomes more exposed to compression injury secondary a disc bulge, disc herniation or bone spur because it is fixed in place and unable to move out of the way.
Open surgical procedures which are most likely to result in significant scar formation, include spinal fusion, laminectomy, and microdiscectomy. Some degree of scar tissue develops after each surgical procedure, but it contributes to persistent or new symptomatology in a small percentage of cases
Scar tissue may be associated with intractable pain due to its capacity to limit tissue movement and promote chronic inflammation. Scar tissue (fibrosis) can adhere to or wrap around a spinal nerve. It can create adhesive or restrictive bands between adjacent spinal structures. Scar tissue tends to have a good blood supply therefore when it is physically stretched it tends to bleed easily. The presence of recurrent microinjury and resultant bleeding promotes further scar tissue development (fibroproliferation). Epidural scar (fibrosis) can develop within 2-12 weeks of surgical intervention.
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