Why Most Back Surgeries Fail

by Apr 23, 2018

Tens of thousands of Americans—by some estimates, more than 80,000 yearly—are suffering due to back surgery failure. Despite having one or more spinal surgeries, they continue to have chronic low back and/or leg pain. In addition, many of these patients also experience depression, brought on by continued disability. The term commonly used to describe this condition is called failed back surgery syndrome.

Failed back surgery syndrome statistics show that anywhere from 10-40% of patients are affected. Why is the back surgery failure rate so high? Much of it is due to the major shortcomings of two common types of back surgery—fusion and disc replacement.

How Fusion & Disc Replacement Contribute To High Failed Back Surgery Statistics

Even though both spinal fusion and disc replacement have been shown to work biomechanically, few patients experience complete relief from either option. Here’s why:

1. Fusion doesn’t preserve range of motion.

One of the shortcomings of spinal fusion is that it does not preserve patients’ natural motion.

Your spine has three parts: the disc, which carries the load of your body; and two small facet joints to control motion. In most fusion procedures, the surgeon removes all or part of both the facet joints and the affected disc, and fuses two vertebrae together in their place.

But problems arise as a result of losing a joint. Fusing a motion segment together removes some degree of mobility. And although surgeons try to compensate for this loss, the patient is no longer naturally able to change positions comfortably throughout the day. That eventually leads to poor posture, pain, and muscle fatigue. The inability to move freely leaves many fusion patients feeling discouraged about the outcome of their surgery, with residual symptoms such as back pain. Additionally, the loss of motion also often leads to further surgery down the line (see adjacent segment disease below).

2. Neither fusion nor disc replacement promote long-term back/leg pain relief.

Some fusion patients do experience a degree of postoperative pain relief—for a while. But soon the loss of motion causes many patients to develop strategies to find comfortable positions, whether standing, sitting, or riding in a car. Eventually these altered postures become painful.

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On top of that, fusion patients often suffer from a condition called adjacent segment disease. Through the surgical stiffening of a segment—where there was once a joint—an abnormal load is placed on the segments above and below the fusion. These abnormal loads add stress to the nearby joints and discs and make them work much harder, outside of their normal range of motion, weakening the whole structure more rapidly than usual. In fact, we are now learning that these abnormal motions may cause breakdown of normal levels—not just diseased levels as previously thought.

All that wear and tear eventually causes loss of disc height with hypertrophy and thickening of the spinal bones and ligaments, leading to spinal stenosis. The load-carrying capacity of the discs may wear out, which could lead to spondylolisthesis or a herniated disc. Symptoms of adjacent segment disease are back pain, pain that radiates down your legs, and difficulty standing and walking.

Disc replacement also falls short when it comes to long term pain relief. In disc replacement surgery, a surgeon replaces a degenerated or worn disc with an artificial one. But simply replacing a disc does not address the most common causes of back and leg pain, such as pinched nerves and arthritis. For a surgery to successfully address back and leg pain relief, then, it must allow the surgeon to directly unpinch the nerves—which artificial disc replacement surgery does not do. And because disc replacement surgery replaces only one of the three potentially diseased segments (a disc and two facet joints), it also won’t address pain arising from degenerating or arthritic facet joints.

Reduce Your Chances Of Back Surgery Failure With BalancedBack

Until now, people with debilitating lower back and leg pain had no choice but to try either fusion or disc replacement with the hope of indirect decompression. Today, there’s another option: BalancedBack Total Lumbar Arthroplasty (total joint replacement). BalancedBack represents a huge step forward for those suffering from leg and back pain, because it addresses the shortcomings of fusion and artificial disc replacement. BalancedBack patients have a better chance of a successful outcome because they:

  • Preserve their natural range of motion. A BalancedBack implant replaces the function of the entire joint—facet joints and disc. So your spine regains its natural range of movement and retains its natural curve. That means you can find comfort in any position, and participate in the activities you loved before you had back/leg pain.
  • Experience high levels of back/leg pain relief. The BalancedBack procedure is performed using a posterior approach (from the back), which means your surgeon can directly address a number of other back and leg pain conditions—including pinched nerves from spinal stenosis—while implanting the device.

If you’re interested in finding out more about the BalancedBack procedure and whether or not it might work for you, visit our website.