There’s no denying the fact that revision spine surgery represents a significant disappointment for patients. Nobody wants to hear that their first surgery didn’t address the problem and that they need to go back for more. Unfortunately, there are some instances where revisions are required. Here are the most common reasons.
Repeated Disc Herniations
Patients who have undergone discectomy sometimes continue to experience their original symptoms. This is an indication that the problem has not been completely addressed. In many cases the issue is that the disc fragments left behind in the original surgery continue to herniate.
When spinal fusion surgery is performed, it is done with the hope that new bone will form. In up to 68% of procedures performed, this still has not occurred one year later. In some of these cases another procedure will be required.
There are many reasons why psuedoarthrosis may occur, including whether hardware such as plates, or screws are used, the type of hardware or bone graft used, or the patient’s own health condition or habits.
Adjacent Segment Disease
This condition does not arise immediately; rather it appears two or more years after surgery that has been considered successful. When it does arise, it is defined as anatomical changes in the joints above or below the surgical site.
It is unclear whether ASD is driven by degenerative disease that would have occurred with or without the previous surgery, or as a result of the surgery itself. Studies have supported both theories.
Some patients who have undergone total disc replacement, or TDR, have required revision surgery. Total disc replacement is not a good option for every patient, and because it is a relatively new surgical technology there are some instances where patients who are thought to be good candidates experience complications such as device failure that requires a second disc replacement surgery.
Sometimes these failures are malfunctions or shifting of the prosthetic disc leading to pain. In other cases, the issues following total disc replacement involve degenerative changes at the facet joints. In cases of failure of total disc replacement, spinal fusion may be recommended.
Occasionally, the hardware that is implanted during spine surgery can break or may have been placed improperly. These hardware items may include prosthetic discs or what is needed to perform spinal fusion.
There are also occasional instances of “painful hardware” in which patients are simply unable to get comfortable or continue to suffer. This is frequently a result of muscles, tendons, ligaments or fascia becoming sensitive to the hardware.
Painful Hardware is generally evident soon after the original surgery. Whatever the reason for it, if the patient cannot find relief the hardware will need to be removed.
Our lumbar spine specialty practice understands the frustration that arises when revision spine surgery is necessary. We are here to help explain why it is necessary, what the required steps will be, and to take care of you every step of the way.
Contact us today to learn how we can provide you with relief.