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Failed back and revision surgery

Revision surgery

When pain persists after one or more operations, the key is to tell whether there is a mechanical problem left to correct or whether the nervous system itself is sustaining the pain.

Frequently asked questions

Restructuring a previous operation that has not solved the problem or has created a new one.

Non-union, misplaced implants, degeneration of the neighbouring segment or a back that has lost its curve after a fusion are mechanical problems that can be corrected surgically.

These are demanding cases, where experience weighs more than any technology. They are planned with the same balance study as a deformity and, whenever possible, through routes that avoid crossing the previous scar again.

Typical indications

  • Non-union (pseudarthrosis)
  • Adjacent segment degeneration
  • Post-surgical flat back
  • Recurrent compression

Frequently asked questions

Which problems from a previous operation can be put right?

The mechanical ones: a non-union — a fusion that never knitted — misplaced implants, degeneration of the neighbouring segment, or a back that has lost its curve after a fusion. All of these can be corrected surgically.

Will you open through the same scar again?

Whenever possible, no. Routes are planned that avoid crossing the previous scar again, because tissue that has already been operated on does not behave the same way. Whether that is possible depends on where the problem to be corrected lies.

What work-up is needed first?

The same balance study used for a deformity: it is not enough to look at the operated level, you have to see how the whole spine sits over the pelvis. Many failures only make sense when the whole picture is looked at.

What if my pain is not coming from a mechanical problem?

Then it is not a revision case, and operating will not improve it. That is the territory of persistent spinal pain syndrome, where the answer lies in neuromodulating drugs and, if they are not enough, in spinal cord stimulation. Telling one from the other is the most important part of the assessment.

The information on this page is for guidance only and does not replace a personalised medical assessment. Whether any technique is indicated depends on each patient's examination and scans.

Other techniques in failed back and revision surgery

Back to the catalogue See the whole group in the catalogue

Could one of these fit your case?

I review your scans and tell you frankly which option makes sense, including not operating.

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