What is revision spine surgery?
Revision spine surgery is an easy way for describing a very complex network of problems with a similar complex array of possible solutions. Revision surgery can be needed due to failure of the hardware, a new disk herniation, failure of all of bones to fuse or mend together, pathology at another level, or for any other multitude of problems that may develop. Overall, spine surgery is quite successful, but occasionally a patient or a condition may necessitate a revision spine surgery.
So, how do I know if I need revision spine surgery?
Typically patients will experience some sort of pain, or failure of the initial surgery to alleviate the pain. Although every patient’s scenario is unique, often with a failure of fusion, also known as Pseudoarthrosis, the patient usually has decent pain relief initially, then the pain returns and may be relentless. This is due to the fact that the bones did not fully mend together.
Regarding disk herniations, if for instance, a patient had a Diskectomy to alleviate pressure on a nerve, these patients typically do well for a while, but if the disk re-herniates, the patient may have the same symptoms that they had prior to the initial surgery. These are examples of patient that may or may not need a revision spine surgery.
How is revision spine surgery managed or treated? Treatment is based on patient’s symptoms and the pathology that is going on. Not all patients are the same, and not all revision spine surgery is the same. As long as there is no neurological damage, conservative management can be attempted first. This includes physical therapy, injections and anti-inflammatory medications. When pain becomes relentless or if neurological changes occur, surgery may be offered.
There are many studies from the Scoliosis Research Society and from the medical literature describing the long term benefits of surgery for revision spine surgery, but patient’s expectations need to be realistic. Recovery requires time and patience. The risks are usually a little higher and surgery is more challenging. There is usually scar to contend with and possibly hardware to remove or replace.
Being a Diplomat of the American Board of Orthopaedic Surgery and a member of the Scoliosis Research Society, I tailor every surgical decision making process to each unique patient and their specific disc pathology using evidence based medicine. This can vary, obviously, depending on the pathology and the patient.