What does preparing for an FBSS consultation actually involve?

Preparing for a Failed Back Surgery Syndrome consultation means organizing your medical records, documenting your pain history, listing every prior treatment, and writing down your questions before you walk in. The more complete your information, the more targeted the evaluation your clinical team can provide.

If back pain has persisted or returned after spine surgery, you are not alone. Failed Back Surgery Syndrome (FBSS) affects a substantial portion of patients who undergo lumbar procedures. Back surgery carries roughly a 40% failure rate — a figure drawn from the peer-reviewed FBSS literature — yet most patients who reach that outcome are simply told to wait, manage symptoms, or consider another surgery. A well-prepared consultation is where a different path can begin. Individual outcomes vary, and a clinical evaluation is the only way to know what options apply to your situation.

Step 1: What medical records should you bring?

Bring every document that traces your spine history: operative reports from prior surgeries, post-operative notes, MRI and CT imaging reports, X-rays, physical therapy discharge summaries, and records from any pain management procedures. The clinical team needs to understand the full arc of your treatment — what was attempted, what was found, and what changed after each intervention.

If you have imaging on disc, request the actual DICOM files (not just printed reports) so the team can review the images directly. Original imaging allows for a far more precise assessment of disc integrity than a summary report alone.

Step 2: How should you document your current pain?

Write out a pain narrative before your appointment. Cover the location of pain, its character (sharp, burning, aching, tingling), its intensity on a 0–10 scale at its best and worst, and what makes it better or worse. Note any radiating symptoms into the legs or arms, any numbness or weakness, and whether symptoms have changed since your surgery.

A specific, detailed pain history allows the evaluating clinician to correlate what you are experiencing with potential anatomical sources — including disc tears that may not have been addressed by the original procedure. For more on how post-surgical pain patterns relate to disc pathology, see How to Get Answers for Your Post-Surgery Back Pain.

Step 3: Why does your treatment history matter so much?

A complete treatment history prevents the clinical team from recommending approaches your body has already failed to respond to, and reveals patterns that point toward underlying disc pathology.

List every treatment you have tried: medications (prescription and over-the-counter), epidural steroid injections, nerve blocks, physical therapy, spinal decompression, chiropractic care, acupuncture, and any others. For each, note the approximate duration of use, who provided it, and what effect it had — including how long any relief lasted. The American Academy of Family Physicians’ systematic review found epidural steroid injections not effective for chronic low back pain; if that treatment is on your list without lasting benefit, documenting it clearly advances the conversation toward other options.

Step 4: What questions should you prepare for the specialist?

Prepared questions produce better consultations. Write them down before you go so that nothing is forgotten under the stress of the appointment.

Useful questions to consider:

• What diagnostic steps will you use to identify the source of my ongoing pain?
• Is an annulogram part of the evaluation process, and what would it show?
• What non-surgical options are available for patients who have already had spine surgery?
• Am I a candidate for intra-annular fibrin injection, and how would you determine that?
• What does recovery from the fibrin procedure look like for someone with my history?
• What outcomes data exists for patients who have already had failed surgery?
• What happens if I am not a candidate for this approach?

Among the most-tracked outcomes in the fibrin procedure registry — over 7,000 procedures with long-term follow-up — the success rate is 83%, and 80% of patients who had previously undergone failed surgery reported positive outcomes. Individual outcomes vary; these are population-level statistics, not personal guarantees. For additional context on how to evaluate spine repair options after surgery, that resource walks through the decision framework in detail.

Step 5: How do you communicate your goals clearly?

Before your appointment, think through what a successful outcome actually means to you — not just in abstract terms, but in concrete functional ones. Do you want to return to a specific activity, sleep through the night without pain, reduce dependence on medication, or return to work? The more specific your goals, the more precisely the clinical team can assess whether a given treatment path aligns with them.

Be direct about what you have already tried and why you are seeking a different approach. Clinicians who specialize in FBSS understand that most patients arrive after a long and frustrating journey. Honesty about expectations — including realistic ones — leads to better shared decision-making.

Step 6: What medication and allergy information do you need?

Bring a complete, current medication list: prescription drugs, over-the-counter medications, vitamins, supplements, and herbal remedies, with dosages and frequency. Include a full allergy history, especially to medications, anesthetics, and contrast dyes used in imaging procedures.

This information is not bureaucratic — it directly affects which diagnostic and treatment steps are safe for you. Contrast dye allergies, for example, are relevant to imaging-guided procedures. Anticoagulant medications may require adjustment before certain interventional steps. Completeness here protects you.

Should you bring someone with you to the consultation?

Bringing a trusted person to your consultation is a practical decision, not just an emotional one. A second set of ears absorbs information you may not retain under stress, takes notes during the discussion, and can help you recall the details afterward when you are reviewing your options.

Ask them to focus on listening rather than contributing during the clinical portion. Their role is to help you remember and process — not to advocate in ways that redirect the evaluation. After the appointment, their recollections can fill in gaps in yours.

What happens after the consultation?

A thorough FBSS evaluation does not end with one conversation. If the clinical picture points toward unresolved disc pathology — annular tears that survived or were not addressed by the original surgery — the next diagnostic step is typically an annulogram. This imaging-guided procedure identifies every active tear and leak in the affected discs, producing the specific information needed to determine whether intra-annular fibrin injection is appropriate for your anatomy.

Not every patient with FBSS is a candidate for the fibrin procedure. A clinical evaluation is the only way to know for certain. What the consultation does is establish whether the diagnostic pathway makes sense for your specific history and presentation. See also: How to Evaluate Non-Surgical Disc Repair When Surgery Failed and 80% Pain Reduction After Failed Fusion — an illustrative case study drawn from the patterns seen in patients with similar histories.

Frequently Asked Questions

What is FBSS and why does ongoing pain happen after spine surgery?

Failed Back Surgery Syndrome describes persistent or new back pain that continues after spine surgery. It occurs because surgery may address structural compression without sealing the underlying disc tears that continue to cause pain. For a full explanation, see What Is Failed Back Surgery Syndrome?

Will the clinical team want to see my actual MRI images or just the reports?

Both are useful, but original DICOM imaging files allow for direct review of disc integrity, which is more informative than a written summary alone. Request the files from your imaging center before your appointment.

Is intra-annular fibrin injection an option if I have already had spine surgery?

For some patients with FBSS, the fibrin procedure addresses disc tears that were not resolved by the original surgery. Among the most-tracked outcomes in the procedure registry, 80% of patients who had previously undergone failed surgery reported positive outcomes. Individual outcomes vary. A clinical evaluation and annulogram determine candidacy.

How long does the consultation typically take?

The Valor team structures consultations to allow adequate time to review your history and answer your questions. Coming prepared — with records organized and questions written down — makes the time more productive for both you and the clinical staff.

What if I am not a candidate for the fibrin procedure?

Not every FBSS patient is a candidate, and the evaluation is designed to determine that honestly. If the fibrin procedure is not appropriate for your anatomy or history, the clinical team will explain why and discuss what other options exist. A clinical evaluation is the only way to know for certain what applies to your situation.

Can veterans with FBSS access this evaluation through the VA?

Under the Mission Act, the fibrin procedure may be a covered VA benefit when the VA cannot provide timely or appropriate care. Valor works directly with VA referral coordinators — veterans do not need to navigate that process alone. VA coverage is determined case-by-case by the VA, not by Valor Spine.

This content is for general informational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for evaluation by a qualified physician. Treatment decisions depend on your individual medical history and clinical findings. Schedule a consultation to discuss whether the procedure is right for you.