Recurrent spinal pain following spinal surgery is not uncommon and can be caused by several varying factors. Discovering the underlying root of the patient’s pain and developing a comprehensive treatment plan can help patients find relief from pain after surgery.
Back or neck pain occurring after spinal surgery may not be related to the surgery itself and may have several possible causes, including the development of a new disc herniation, advancing degenerative disc disease, degenerative arthritis of the facet joints and spinal stenosis that causes low back and radicular pain. In some patients, pain can be caused by the presence of scar tissue that develops after spinal surgery. Facet or disc pain at the adjacent spinal levels following fusion surgery also may occur over time.
“Reasons for recurrent spinal pain are varied and can be completely unrelated to the surgery that was performed,” says Richard S. Epter, M.D., Medical Director of the Augusta Pain Center. “In some cases, recurrent pain is caused by the same factors that originally made patients seek surgical treatment. For example, in patients with chronic degenerative disc disease occuring as a result of aging, it is not uncommon for the degenerative disease process to continue advancing, necessitating further treatment.”
Available Modalities
To determine which treatment modality will provide optimal pain relief, Dr. Epter first performs a comprehensive evaluation of the patient’s medical history, as well as a physical exam and appropriate radiologic studies. Based on those findings, diagnostic interventional studies that help to identify the patient’s specific pain generators may be used. Once the structure responsible for pain has been identified, a treatment plan, which may consist of diagnostic or therapeutic injections or radiofrequency procedures — minimally invasive techniques that involve either applying electrical current to a nerve to decrease painful impulses or burning the nerve to disrupt neural pathways — will be tailored to meet each patient’s specific needs.
For patients experiencing persistent refractory chronic pain non-responsive to more conservative interventions, spinal cord stimulation may be recommended. Used to control axial spine pain or extremity pain following back or neck surgery, spinal cord stimulation involves placing a lead over the spinal cord that provides current to help block the transmission of painful nerve impulses.
For patients who experience pain as a result of scarring that occurs during the healing process, epidural lysis of adhesions may be effective. This treatment option is performed using fluoroscopic guidance and involves advancing a specially designed catheter through the epidural space to the target location where scarring has occurred. The purpose of this procedure is to eliminate scar tissue and deliver medication to the site of pain.
“There are a number of options available to treat recurrent pain after spinal surgery,” says Dr. Epter. “Unfortunately, many patients are told that there is nothing else that can be done after surgery has been unsuccessful in managing pain. At the Augusta Pain Center, we use a multidisciplinary approach to treating recurrent spinal pain that involves use of medications, injections, minimally invasive spinal procedures, aquatic or physical therapy, and behavioral pain management.”
To learn more about the services provided through the Augusta Pain Center, visitwww.augustapaincenter.com or call (706) 738-PAIN (7246).