Southwest Scoliosis and Spine Institute Revision Surgery
Shawn Coker, watch his video had multiple spine fusion surgeries. While he says they accomplished what they were supposed to do at the time, his condition continued to get worse. Sadly, his spine caused him pain and forced him to lean forward constantly.
This made it difficult for Shawn, who had always been an active person, to walk for any kind of distance. Also, he could not do things he loved, like traveling. After looking everywhere, he came to the Southwest Scoliosis and Spine Institute where he met with Dr. Hostin. Dr. Hostin suggested revision surgery to correct the problem.
Recovery went much quicker than he expected, and within two weeks he was walking around better than before – without pain!
What is Revision Spine Surgery?
Revision spine surgery uses procedures to stop the pain. To do so, doctors focus on the effects of nerve damage, such as numbness and tingling in the extremities, as well as conditions like spinal instability or herniated discs following previous spine surgery.
Usually, within about three months after spine surgery, pain should not exist. However, in some cases (around 10-40%), an initial procedure might not produce the desired benefits and results. Doctors often refer to this as failed back surgery syndrome (FBS). When this happens, doctors usually suggest revision spine surgery.
What causes Failed Back Surgery Syndrome or FBS?
Despite the name, Failed Back Surgery Syndrome isn’t really a syndrome at all. It refers to the presence of chronic issues after one or more back surgeries. There are a variety of causes, including certain disorders and diseases that can inhibit healing. A few of those are as follows:
- Autoimmune disorders
- Peripheral artery disease
Smokers are also at higher risk. Cigarette smoking (and nicotine use in general) has been proven to inhibit and impair the healing process. This occurs because nicotine constricts small blood vessels and capillaries. This interferes with the body’s ability to heal and increases scar formation, and generally impedes successful bone fusion. In addition to pre-existing conditions like these, other problems can develop. These problems occur months or even years after the initial surgery, and therefore, make revision surgery necessary.
Other common issues and injuries that lead to the need for revision spine surgery include:
- Recurring disc herniation(s)
- Flatback syndrome
- Failure of the spine to fuse properly
- Formation of scar tissue at the surgery site
- Post-surgical infection
- Failure of a spinal implant or hardware
- Other changes unrelated to prior surgery
In many cases, these kinds of conditions develop as a result of normal wear and tear on the spine. However, those who conduct manual labor or who engage in contact sports or other rough activities may likely need more surgery.
Is Revision Spine Surgery the only way to treat Failed Back Surgery Syndrome?
In many cases, the doctors at Southwest Scoliosis and Spine Institute suggest non-surgical treatments. Only after these treatments do not work will the doctors suggest revision surgery. This is because our doctors believe that surgery is a last resort due to the risks involved.
Non-surgical treatment includes things like:
- Physical therapy
- Exercise therapy
- Steroid injections (ESIs)
Even though non-surgical treatment is the preferred starting point. Doctors may suggest immediate revision spine surgery if you have any of the following conditions:
- Serious nerve-related pain or weakness, shooting pains, and numbness – especially in the legs
- Bowel and bladder problems
- Spinal instability
- Broken or displaced spinal rods & screws that could damage nerves or vascular structures
- Spinal infection
We’re here to help STOP THE PAIN
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Surgical treatments for Failed Back Surgery Syndrome
If your doctor says that more surgery is necessary, the goal is to reduce or stop the pain and allow you to return to life as normal.
To do this, revision spine surgeries fall into one of two categories: decompression surgery or stabilization surgery. In some cases, decompression and stabilization are performed at the same time.
Common decompression surgeries include:
- The removal of a herniated or damaged disc that is pressing on the spinal cord or nerves.
- The surgeon enlarges the opening(s) between the affected vertebrae through which the nerve roots exit the spine.
- Involve partial or complete removal of the lamina, which is the rear portion of the vertebrae.
The goal of any decompression surgery is to relieve pressure on the spinal cord and nerves, but this surgery alone may lead to more problems by causing spinal instability when creating added space between your vertebrae. This added space allows the vertebrae to move more freely than they should, and this can make your spine less stable. If a decompression surgery threatens the stability of your spine, your surgeon will also perform a stabilization procedure during the same surgery.
The primary surgery to stabilize the spine is a spinal fusion, which limits any abnormal motion or range of motion between vertebrae. This prevents the vertebra from moving too much or moving out of place, which can cause them to put pressure on the spinal cord and nerves.
By fusing together two or more vertebrae, usually with a bone graft, a spinal fusion procedure allows the vertebrae to grow together, or fuse. Because this takes some time, a spinal fusion is typically held in place with rods and screws that support the healing bone and allow your spine to fuse properly.
How do doctors determine if a patient needs revision surgery?
To properly test for and diagnose a patient with FBS, the doctors at Southwest Scoliosis and Spine Institute perform a number of tests that are needed to discover what caused the initial surgery or surgeries to fail and then determine the best way to fix the issue.
Evaluations and testing always start with a thorough examination, during which the doctor will carefully go over your medical history with the patient. Next, they will utilize state-of-the-art imaging EOS to get an accurate model of your entire spine.
Diagnostic imaging options may include:
- X-ray imaging to check the spine and ensure that any implanted hardware is intact
- CT scans to determine if vertebrae have fused properly and check for things like fractures
- MRI scans to detect nerve or disc problems
- EMG to study nerve functions
- Bone scans to rule out the possibility of infection
Once these tests have been performed, our team of experts will review the findings to diagnose the problem and determine the best possible course of treatment. The doctor will then sit down with the patient to discuss all of the options available, as well as answer any questions they may have.
Revision Spine Surgery recovery
Depending on the exact procedure and the reason for revision surgery, recovery times for each patient will vary. However, most surgeries will require the patient to stay in the hospital for several days to allow their Surgeon and team of doctors to monitor them and ensure there are no problems.
After the surgery, patients get fitted with a brace or collar to help keep their spine stable during recovery, and during the first few weeks, the doctors will restrict their activities.
However, as healing progresses, the patient will slowly resume normal activities again. That’s why physical therapy after surgery is so important and should begin as soon as possible to help regain strength and movement.
Depending on the nature of the revision spine surgery, recovery times vary between six weeks and three months, with a full recovery usually in six months.
The exception is that some revision spine surgeries occur using minimally invasive techniques, in which the surgery is done by making small incisions with specialized instruments. This method causes less damage to the muscles and tissues around the spine and involves a much quicker recovery time as compared to open surgical methods.
Southwest Scoliosis and Spine Institute specializes in treating complex spine conditions and revision surgery
If you think you may need revision spine surgery, it’s critical to consult a doctor who is skilled in performing these kinds of complex procedures – especially if it’s the result of earlier surgery.
At our practice, our board-certified, fellowship-trained orthopedic surgeons have performed more than 5,900 successful spine surgeries, helping more than 100,000 patients.