Failed Neck/Back Syndrome

Failed Neck/Back Syndrome, also known as Failed Back Surgery Syndrome (FBSS), refers to persistent pain or dysfunction after spine surgery.
While most spinal surgeries are successful, in some cases, patients may continue to experience pain, numbness, weakness, or limited mobility even after the procedure has healed.

This does not always mean the surgery was performed incorrectly — sometimes the cause of pain is complex, or new issues develop over time.
Dr. Tristan Fried specializes in evaluating complex cases to identify why symptoms persist and to develop a personalized plan for relief.

Failed Neck/Back Syndrome can result from many factors.
Some are related to the original condition, while others arise after surgery.

• Scar tissue formation (epidural fibrosis): normal healing tissue can sometimes irritate or trap nerves.
• Incomplete nerve decompression: residual bone, disc, or ligament still compresses the nerve.
• Spinal instability or degeneration: new degeneration at the operated level or adjacent levels over time.
• Recurrent disc herniation: a disc re-herniates after initial repair.
• Misdiagnosis or untreated underlying condition: the original pain source wasn’t fully identified.
• Hardware issues: screws, rods, or implants may loosen, shift, or cause irritation.
• Poor fusion healing (pseudoarthrosis): bones do not successfully fuse together after surgery.
• General health factors: smoking, obesity, diabetes, or poor bone quality can affect healing and outcomes.

Patients with Failed Neck/Back Syndrome may notice symptoms similar to those they experienced before surgery, or new problems altogether.

• Persistent back or neck pain that does not improve after healing time has passed.
• Radiating nerve pain down the arms or legs (sciatica or cervical radiculopathy).
• Numbness, tingling, or weakness in the extremities.
• Stiffness or limited range of motion in the neck or back.
• Worsening symptoms over time, especially with activity or standing.
• Emotional effects, such as frustration, anxiety, or depression, due to ongoing pain.

Severe or sudden neurological changes — like loss of bladder or bowel control — require immediate medical attention.

Determining the cause of persistent pain after spine surgery requires a comprehensive evaluation.
Dr. Fried uses advanced diagnostic techniques to create a clear picture of the problem.

• Detailed medical history: including surgical records, prior imaging, and a timeline of symptoms.
• Physical and neurological exam: assessing strength, reflexes, sensation, and mobility.
• Imaging studies:
  • MRI: to evaluate scar tissue, nerves, and recurrent disc issues.
  • CT scans: for bone detail, hardware position, and fusion healing.
  • X-rays: to check spinal alignment and movement.
• Diagnostic injections: to pinpoint whether pain is coming from nerves, joints, or muscles.
   

Treatment focuses on identifying the root cause of ongoing pain and improving function.
Dr. Fried prioritizes non-surgical care first, with revision surgery reserved for cases where a clear structural issue is identified.