Non-surgical treatment is aimed at addressing pain and improving physical function. Options for management include:

• Anti-inflammatory and pain medicines (NSAIDs, Tylenol, muscle relaxants, opioids)
• Antidepressants and antiepileptics that are effective for nerve pain
• Chiropractic and Acupuncture
• Physical therapy
• Epidural steroid injections

Surgical management may be indicated in carefully selected candidates if a surgically correctable abnormality is found. Treatment options include:

• Revision decompression surgery including a minimally invasive laminectomy or an ultra-minimally invasive endoscopic laminectomy
• Stabilization surgery including a minimally invasive outpatient fusion.
• Pain management techniques such as radiofrequency ablation, nerve blocks, and epidural steroid injections.
• Cognitive behavioral therapy.

Examples of reasons for surgical intervention include misalignment, spinal imbalance, nonunion (when a bone graft does not properly fuse the bones around it), nerve compression, or recurrent disc herniation. For a recurrent herniated disc, the disc may need to be partially, or completely removed with either a minimally invasive tubular microdiscectomy or via an ultra-minimally invasive endoscopic discectomy.

For a nonunion, another bone graft or bone graft substitute with possible hardware may be needed to stabilize the lumbar spine. In almost all situations, Dr. Singh is able to correct the non-union via a minimally invasive outpatient lumbar spinal fusion.

Each case of failed back surgery syndrome is unique and treatment is always personalized based on the underlying causes and symptoms. It is important for patients to work closely with their healthcare team including Chicago spine surgeon Dr. Kern Singh, pain management specialists and physical therapists to tailor a plan to their needs.