Failed Back Surgery Syndrome (FBSS) is the persistence or recurrence of pain after spine surgery, occurring in roughly 40% of fusion patients. For patients with FBSS whose pain is driven by unrepaired annular tears, intra-annular fibrin injection offers a non-surgical path that addresses the lesion directly without revising the prior surgery.
Key Takeaways
- FBSS is documented in roughly 40% of fusion patients.
- The pain driver in FBSS is commonly an unrepaired or new annular tear.
- The fibrin procedure addresses the tear directly.
- 80% of patients with prior failed surgery reported positive outcomes in published cohorts.
- Treatment focuses on discs unaffected by surgical hardware.
What This Guide Covers
- What is FBSS?
- Why does FBSS happen?
- How does fibrin treatment fit for FBSS patients?
- What does FBSS evaluation include?
What is FBSS?
Failed Back Surgery Syndrome is the persistence or recurrence of significant back or leg pain after one or more spine surgeries. The term is used in the peer-reviewed literature and reflects a real pattern: roughly 40% of fusion patients experience some form of FBSS. The label is descriptive rather than diagnostic — the clinical question is what specifically is driving the pain in a given patient.
Why does FBSS happen?
FBSS happens for several reasons. The original surgery does not always have addressed the actual pain driver. Adjacent-segment degeneration commonly develops at levels above or below the fused segment. New annular tears can form at adjacent levels. Surgical scarring can produce its own pain pattern. Each of these has different implications for treatment.
How does fibrin treatment fit for FBSS patients?
The fibrin procedure addresses annular tears at discs unaffected by prior surgical hardware. Among published cohorts, 80% of patients with prior failed surgery reported positive outcomes after the procedure. The procedure does not revise the prior surgery; it targets the lesion driving current pain.
What does FBSS evaluation include?
Evaluation includes review of pre- and post-surgical imaging, current MRI, the operative report, and a focused history and exam. The Valor team identifies whether the current pain driver is an annular tear, hardware-related, scar-related, or a different pattern entirely. Treatment recommendations follow from that finding.
Clinical Note
FBSS patients often carry a sense of having “used up” their surgical options. Our clinical staff frames it differently: surgery is one tool, but it is not the only tool, and prior surgery does not preclude future treatment. Many FBSS patients we see have unaddressed annular tears at adjacent levels that the original surgery never targeted. When imaging shows that lesion clearly, sealing the tear is a path forward that does not require revising the prior procedure. Honest evaluation determines whether that path applies in a specific case.
Frequently Asked Questions
Is the fibrin procedure considered a revision surgery?
No. It is a non-surgical procedure that addresses a different lesion, not a revision of prior surgical work.
How long after fusion can the procedure be considered?
Most patients are eligible to evaluate the procedure once they have completed standard post-fusion recovery.
What if my pain is hardware-related rather than disc-related?
The procedure does not address hardware-related pain. The evaluation identifies the actual driver and recommends accordingly.
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.
