Failed Back Surgery Syndrome (FBSS)—also referred to as Post-Laminectomy Syndrome—is a condition where a patient continues to experience chronic back and/or leg pain after spinal surgery. Despite technically successful procedures such as laminectomy, discectomy, or spinal fusion, the patient does not achieve the expected relief, or the pain may worsen over time.
FBSS does not imply a surgical error, but rather reflects the complexity of spinal pathology and how pain can persist or evolve even after intervention.
Common Causes of Failed Back Syndrome
FBSS can result from a variety of factors, including:
Residual or recurrent disc herniation
Scar tissue formation (epidural fibrosis) compressing nerves
Spinal instability or hardware failure
Adjacent segment disease (new degeneration above or below a fusion site)
Persistent nerve root inflammation or damage
Improper patient selection or incomplete diagnosis (e.g., unrecognized facet joint or sacroiliac joint pain)
Central sensitization or chronic pain syndrome developing after surgery
Symptoms
Persistent low back pain or neck pain
Ongoing leg or arm pain (radiculopathy), often similar to pre-surgery symptoms
Numbness, tingling, or weakness in the extremities
Limited mobility and function
Depression or anxiety related to chronic pain
Non-Surgical Treatment Options
Medication Management
Anti-inflammatory medications (NSAIDs)
Neuropathic pain medications (e.g., gabapentin, pregabalin)
Muscle relaxants or antidepressants
Opioids (short-term or carefully managed chronic use, if indicated)
Physical Therapy & Rehabilitation
Focused on core strengthening, postural correction, and mobility restoration
Functional movement training to reduce pain and improve daily activities
Behavioral Therapy
Cognitive Behavioral Therapy (CBT) or pain psychology to address emotional components of chronic pain
Interventional Pain Management Options
Interventional procedures are a cornerstone of effective treatment for FBSS, especially when pain is refractory to medications or physical therapy:
Epidural Steroid Injections
Reduces inflammation around nerve roots compressed by scar tissue or recurrent disc herniation
Medial Branch Blocks & Radiofrequency Ablation (RFA)
Targets facet joint pain, which is a common overlooked contributor to post-surgical pain
RFA can offer 6–18 months of relief with a single procedure
Sacroiliac (SI) Joint Injections
Identifies and treats SI joint dysfunction, which often mimics spinal pain after lumbar fusion
Spinal Cord Stimulation (SCS)
One of the most effective treatments for FBSS
A small implanted device delivers electrical pulses to the spinal cord to modulate pain signals
Proven to significantly reduce pain, improve quality of life, and reduce the need for opioids
Peripheral Nerve Stimulation (PNS)
Used for more localized pain patterns or focal nerve injury
Adhesiolysis (Racz Procedure)
Breaks up scar tissue (epidural fibrosis) that may be entrapping nerves post-surgery
When to Seek Help
If you’ve had spine surgery and are still experiencing:
Persistent back or leg pain
New or worsening nerve symptoms
Dependence on medication to function
It may be time to re-evaluate your pain and explore advanced treatment options.
Personalized Pain Solutions After Spine Surgery
At Parkview Spine & Pain, we specialize in diagnosing and treating complex post-surgical spine conditions. With a blend of advanced imaging, interventional techniques, and personalized care, we help patients with Failed Back Surgery Syndrome regain function and reduce pain—without repeat surgery in most cases.
👉 Schedule a consultation today to explore real solutions for your persistent back pain.