Southwest Scoliosis Institute is a true leader in treatment for men, women, and children who suffer from chronic back pain or the onset of new conditions six months or longer after spine surgery.
Spine and Revision Surgery
When Scoliosis or Spine Revision Surgery is performed by another surgeon and the outcome does not reduce pain and discomfort, it’s time to see the experts at the Southwest Scoliosis Institute in Dallas or Plano Texas. Our Scoliosis and spine experts, Doctors Richard Hostin, Shyam Kishan, and Kathryn Wiesman have the expertise and complex surgical skills to correct a failed surgery. Also, our Spine Specialists participate in worldwide research to further understand and improve treatments for Scoliosis and spine conditions.
A failed back surgery is sometimes called Failed Back Surgery Syndrome (FBBS). FBBS occurs when an initial surgery is performed to treat a neck or spine condition and fails to produce the desired outcome. Or, in some cases, surgery had been performed many years ago and the progression of scoliosis or another spine injury necessitates an additional surgery. In view of this, we get referrals from doctors all over the world, trusting us to help with some of the most difficult cases. As a result, we have evaluated over 30,000 patients over the years and completed more than 5,900 successful surgeries.
Why have Spine Revision Surgery?
We are often contacted after failed attempts to alleviate pain and/or progressive symptoms. As an example, we see patients whose original fusion surgery did not heal correctly. When physician reports that “a fusion did not heal correctly”, that means the bone did not grow and fuse the vertebrae together, and this causes pain. In addition, other patients have had hardware that has become loose or broken and the patient needs additional support for the spine to eliminate pain. Several of our patients have spent years in pain — looking for a physician with the expert knowledge, skills, and abilities to have an additional surgical procedure to help. They tell us they wish they had found us earlier in their life because they realize just how much life has been missed because of suffering.
Surgical revisions can pose challenges that were not present with the primary procedures because the normal spine anatomy is now altered from the original surgery. The vascular supply to the spine and surrounding soft tissue may have been compromised from previous surgery, putting the patient at risk of not healing. Scar tissue may be present at the surgical site, which can decrease post-operative functionality even if a solid fusion is achieved. Our conservative and measured approach in assessing and addressing patients will assure a thorough and thoughtful assessment of non-operative and operative options for patients with difficult problems.
Often, it’s the lumbar spine that is the affected area and causing the most pain. Your lumbar spine is what helps you stand straight, sit in a car and drive, walk about the grocery store or a carnival with family. Your spine supports your body, so if one section is in pain, the entire spine is not functioning correctly. Then you either don’t participate in activities or you must have assistance, or a walker to help you.
Some conditions or common reasons a corrective revision surgery may be required are:
- Proximal Junction Kyphosis (PJK)
- Flatback: watch more about Judy Dorsett’s flatback story
- Problems that arose after the initial surgery
- Broken hardware
- A new spine injury or deformity
- Adjacent segment disease (ASD)
- Persistent pain and discomfort – Watch LeRoy Foster’s Video
The most common reason for revision surgeries is pseudarthrosis, a condition in which the spine did not heal correctly after the initial procedure. Patients also may need revision surgery if they develop a new deformity, which is a secondary outcome to their primary surgery.
A Surgical revision may be needed for junctional scoliosis or kyphosis, or Proximal Junction Kyphosis. This condition occurs when the discs above or below the initial fused area of the spine, become worn, possibly shrink and lose their shape. Most cases of PJK happen within the first two years of surgery, it is a risk of adult deformity surgery. This condition usually has lots of pain and occurs right below or above the prior surgery. There is evidence that indicates that prior lumbar and sacrum surgeries have the most probability of becoming problematic. There is also evidence that over-correction and under-correction can both lead to this issue. That’s why it is important to find a spine surgeon with lots of experience with this issue to have a successful corrective revision surgery outcome.
“Revisions are technically demanding surgeries,” Dr. Hostin said. “It can be more difficult to get a successful fusion compared to primary surgeries. We have to be extra careful in preparing the fusion site to make sure we have good clean bones to work with. Especially in adults, we may use a bone-inducing protein that revs up the bone cells to grow faster and more effectively.”
Revision surgeries can be considered for almost any patient who is healthy. We had positive surgical outcomes on healthy patients who are in their 80s. Patients with compromised immune systems or those who have taken steroids for conditions like rheumatoid arthritis may not heal as effectively as those who have not. This is why we spend a lot of time planning the strategy for these surgeries, and every patient goes through a very strict pre-operative regimen to help us identify possible complications and health risks beforehand.
“We conduct a large number of complex procedures and each one has made us smarter and wiser for the next one,” Dr. Hostin said. “We are able to take care of these complex patients and perform these surgeries thanks to the help of our team and the “best processes” that we have put in place. Our best processes have been established through research-based medicine and lots of experience.
Our fellowship-trained orthopedic physicians have extensive specialized training, meaning they participated in additional in-depth instruction, to perfect their skills in orthopedic spine treatment and surgery. Our physicians are also active in research, collaborating with other physicians, world-wide, to further understand and correct spine conditions. There are only a few surgeons in the country who are experienced in performing these complex surgeries.
How to diagnose your spine pain source?
To diagnose the cause of pain or discomfort, at your first appointment with your spine physician he or she will do a very in-depth study of your case. For that reason, please bring any relevant medical records with you for your physician to review. Particularly, your initial evaluation for the condition you wish to be treated for. Along with any spinal surgery notes from your first surgery as this will help identify the surgical site and surgical techniques used by your prior physician. And one of the most important items is your most current imaging reports and CD copies, including X-ray, MRI, CT, and so forth regarding your neck or spine. At your appointment, if you don’t have a recent X-ray of your spine and/or neck, your physician may ask you to take additional X-rays. The good news is that we have the newest technology EOS X-ray imaging machine located in our office. You don’t need to make an extra stop to get this done, we will shoot some new X-rays while you are here, and your physician can review them right away to help diagnose the problem.
Often times, the revision procedure will involve a spinal fusion to correct a spine deformity. During the procedure, your physician will remove scar tissue and utilize a bone graft to fill any gaps in the spine where he or she is trying to fuse the bones together. If any additional herniated discs are present, he will correct those during the surgery as well.
“The core strength of Southwest Scoliosis Institute is our staff,” says Dr. Hostin. “We have a dedicated group of individuals on our team. Our team consists of anesthesiologists, nurses, spinal cord monitoring individuals, and implant specialists. We all work together, and the benefit to the individual patient is that their outcomes are better.”
“If you’ve been told that you need revision spine surgery and have had trouble finding someone to help you, please do not give up hope and please give us a call for an evaluation,” says Dr. Hostin. “Revision spine surgery can help with pain, spinal deformity, and to repair broken rods in your back. It can give you a significant improvement in the quality of life that can be lasting.”
If you or a loved one suffers from spinal pain, you owe it to yourself to call Southwest Scoliosis Institute at 214-556-0555 to make an appointment.