Failed Back Surgery Syndrome (FBSS) is the persistence or recurrence of pain after spine surgery, occurring in roughly 40% of fusion patients. Common causes include unrepaired or new annular tears, adjacent-segment degeneration, hardware-related pain, and scar formation. Alternatives include disc-targeted regenerative treatment for tear-driven cases.
Key Takeaways
- FBSS occurs in roughly 40% of fusion patients.
- Common causes: unrepaired tears, adjacent-segment degeneration, hardware pain, scar.
- Each cause has a different optimal intervention.
- The fibrin procedure addresses tear-driven FBSS in many cases.
- 80% of failed-surgery patients reported positive outcomes in published cohorts.
What This Guide Covers
- What is FBSS?
- What are the common causes?
- What alternatives exist?
- What does FBSS evaluation include?
What is FBSS?
FBSS is a descriptive label for persistent or recurrent pain after spine surgery. The clinical question is what specifically is driving current pain in a given patient — tears, adjacent-segment changes, hardware, scar, or another factor.
What are the common causes?
Common causes include unrepaired annular tears at the operated level, new tears at adjacent levels, adjacent-segment degeneration after fusion, hardware-related pain, and post-surgical scarring. Each requires a different intervention.
What alternatives exist?
For tear-driven FBSS: the fibrin procedure addresses the lesion directly. For adjacent-segment lesions: the procedure targets discs unaffected by hardware. For hardware-related pain: revision surgery can be needed. The intervention follows the cause.
What does FBSS evaluation include?
Evaluation includes pre- and post-surgical imaging, current MRI, the operative note, focused exam, and history of conservative-care attempts since the surgery. The Valor team identifies the active driver and recommends accordingly.
Clinical Note
FBSS patients carry a specific frustration: they did the surgery, recovered, and still have pain. Our clinical staff treats that as a documentation question. Many FBSS patients have addressable lesions at adjacent or operated levels that the original surgery did not target. When the imaging shows the lesion clearly, the procedure is a real path forward. When it shows hardware-related pain, we recommend the right consultation.
Frequently Asked Questions
Can I have the procedure with hardware in place?
Yes, at discs unaffected by the hardware.
Does the procedure undo my prior surgery?
No. It does not revise prior surgical work.
How long after surgery is the procedure considered?
After standard post-surgical recovery is complete.
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.
