Obviously, a failed microdiscectomy, or as it is commonly called “failed back surgery syndrome,” is attributed to an unsatisfactory back surgical procedure that has not been able to relieve the patient’s pain and discomfort and restore a reasonable quality of life.
The causes of a failed lumbar microdiscectomy?
Surgeries carry a certain level of risk, and while many are successful, as Physiotherapists we often are still required for those patients whose surgery is unsuccessful. The reasons for a failed back surgery may be as follows:
- A nerve root bound by scar tissue
- Improper preoperative patient selection before back surgery
- Recurrent disc herniation after spine surgery
- Tenacious post-surgery pressure on a spinal nerve
- Altered joint mobility
- Operating on the wrong spinal level
- Joint hypermobility with instability
- Poor surgical technique causing excessive adhesion formation
- Poor post-operative management
- Spinal muscular deconditioning
Sign and symptoms of a failed microdiscectomy
Typically, failed microdiscectomy is associated with scar tissue around the nerve root appearing at 6 to 12 weeks after back surgery. If there is no improvement after three months, the surgery is unlikely to have been effective.
Treatments after a failed microdiscectomy
The goal of the treatments after a failed microdiscectomy is to mobilize the spinal soft tissues themselves, increase back and core strength, improve flexibility of the spine and surrounding joints, reduce muscle spams, and unload the discs and nerves of the spine.
- Strengthening exercises: To strengthen the global and segmental spinal muscles.
- Stretching exercises: If the nerve is kept movable, it will not be bound by adhesions and the scar tissue should not become a problem. Stretching exercises can help decrease the effects of the scarring around the nerve root after the surgery. 15 minutes of suitable stretching and strengthening exercises per day is recommended for the first months.
- Spinal Decompression Therapy – In cases where the patient is still suffering from nerve impingement Spinal Decompression is often still a a safe non-invasive treatment method, to treat conditions such as a failed microdiscectomy. By applying an accurate computerized traction on your spinal segments, which takes about 30-50 minutes, a negative pressure pulls them away from each other. Therefore, the pressure on the discs and nerves are lessened resulting in a significant regenerative process and decrease in your spinal pain. Spinal Decompression is safe provided there is no pins, plates or hardware stabilizing the spine (such as the case with fusions), and no segmental instability at the level being pulled (such as spinal fractures, severe osteoporosis, etc…)