Revision spinal surgery usually corrects the results of a prior procedure that had been inadequately or improperly performed. Revision surgery is complex and should be performed by a doctor that specializes in it. If you’ve had a neck surgery or back surgery but you’re still experiencing symptoms, or if you get new symptoms, you may have one of the medical issues on the list below. The following diagnoses may necessitate a second or even third spinal surgery, depending on your individual situation. This is known as revision surgery.
1. Recurring Disc Herniations
If, after a discectomy, you again have sciatica, pain down your arm, or other herniated disc symptoms, you may have a recurring herniation. A recurring disc herniation is basically a repeat of the problem that led to the surgery in the first place. A discectomy typically removes only those pieces of disc material (called fragments) that have become partially or fully disengaged from the main disc. You still have your disc, and it is still possible to herniate the part that’s left.
Pseudoarthrosis is when the bones don’t fuse by one year after a spinal fusion surgery. Pseudoarthrosis is fairly common. Some things that may play a role in the development of pseudoarthrosis after your first spine surgery include: the nature of your original diagnosis; the hardware (or lack thereof) installed; the type of bone graft, if any, used; and your health habits and condition. For example, if you smoke or take corticosteroids, your risk for pseudoarthrosis may be increased.
3. Adjacent Segment Disease
Adjacent segment degeneration is a condition in which anatomical changes occur at the spinal joints above and/or below the place a back surgery is done. The fusion places more pressure on the levels below and/or above and can eventually deteriorate those levels.
4. Revision TDR
Total disc replacement, often called TDR for short, is a relatively new surgery (in the United States) that is seen by some spine experts as a viable alternative to spinal fusion surgery. Only 0% to 5% of patients referred for spine surgery fit the criteria for a safe and successful TDR. One of the most common complications leading to a revision TDR is device failure. Examples of device failure include malfunctioning of the prosthetic disc implanted in your spine, or when the device shifts position.
5. Failed Back Surgery Syndrome
Patients who have undergone multiple operations may continue to present with pain. Conditions such as CSF leak, pseudomeningocele, arachnoiditis, pseudo-arthrosis, and sagittal imbalance may be misdiagnosed by surgeons who are not experienced in complex revision work. Dr. Prpa is an expert in diagnosing, treating, and surgically correcting failed back surgery syndrome.