Revision Spine Surgery

Revision surgery may be necessary because of Failed Back Surgery Syndrome (FBSS). Other reasons your doctor may recommend another spinal surgery include adjacent level pathologies, non-surgery related spinal degeneration, herniated discs, spondylolisthesis, pinched nerves or the crankshaft phenomenon. 

Hardware failure, a new injury, infection, errors during surgery, flat back syndrome, pseudoarthrosis (fusion failure) and scar tissue formation are also reasons you may need this procedure. 

The following symptoms are a sign that revision spine surgery could be what you need: 

• New pain that wasn’t there pre-surgery or pain that’s worse
• Nerve pain 
• Pain or numbness that radiates into your limbs 
• Poor healing
• Chronic pain
• Muscle spasms or weakness 
• Back or neck spasms 
• Redness at the surgical site
• Stiffness that inhibits daily activities 
• Incontinence 

If you have any of these symptoms, consult with a spinal specialist. They will be able to determine the right treatment plan and if you need spinal revision surgery. 

The surgical methodology your doctor uses will depend on what issue has caused the initial spinal surgery’s failure. In many cases, your doctor will recommend milder treatments for a minimum of six months before resorting to another surgery.

Revision spine surgery can be either open or minimally invasive. Common minimally invasive procedures used for spinal revisions include microdecompression, cervical or lumbar fusions, laminotomy and foraminotomy.

Procedure length, recovery time and your restrictions will depend on which surgical method your doctor chooses.

With any spinal surgery, it’s normal to feel pain, soreness and stiffness in the affected area – this should improve as you recover in the weeks following your surgery. Your doctor may prescribe pain medications, over-the-counter medications or antibiotics.

You will also have a list of restrictions, which you should follow closely to ensure a smooth recovery. These may include:

• Avoid certain movements. Don’t bend forward or backward or twist your body side to side.
• Follow weight restrictions. Avoid pushing, pulling or lifting items heavier than five pounds.
• Don’t stay sedentary. While you don’t want to participate in rigorous exercise until you’re cleared by your doctor, you also want to avoid sitting for long periods. Taking short walks regularly can help with the healing process. 

Your doctor may also prescribe a back brace and physical therapy.

Revision spine surgeries are technically challenging, and the difficulty level of the procedure depends on the person’s unique pathology. The risk of complications from minimally invasive surgical approaches is much lower compared to open spinal revisions. 

Since there are different risks associated with the procedure your surgeon chooses, ask them what the risks are with your specific procedure. General surgery risks include infection, poor healing, nerve damage, excessive bleeding, blood clots and issues with anesthesia. 

Using tobacco products and specific conditions such as obesity, diabetes, autoimmune disorders and peripheral artery disease can increase your risk of needing a revision spine surgery.