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Pain after Spinal Surgery (Post-Nucleotomy Syndrome)

As soon as a mere few weeks after spinal surgery, many patients start suffering from strong pain again, following a short period without pain. Internationally, this phenomenon is known as Failed Back Surgery. The reason for the pain is usually scar tissue, also known as epidural fibrosis.

During spinal disk surgery in the lumbar area, it is inevitable to open the epidural space and operate there. In recent years, even when using the most sophisticated of techniques, very subtle hemostatis and fine mechanics, it has not been possible to significantly reduce the number of fibroses, meaning excrescent scar tissue. Statistics on this phenomenon vary greatly, ranging from between 7 to 43 percent. Commonly, the rate of fibrosis amounts to between 10 and 15 percent and can not be predicted for individual patients. In our clinic, about one third are fibrosis patients. A short period free of pain for two to three weeks, followed by a renewed appearance of very persistent pain is typical for a fibrosis. With the help of contrast medium, magnetic resonance tomography shows the difference between scar or disk tissue that has slipped after surgery. Unfortunately, therapy for fibroses is very limited since operating again on the scar yields little success and even leads to a more pronounced scarring. Attempts at fixation through surgery are met with little chance of success.


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