There are two main scenarios for revision spine surgery. In some cases a patient has spine surgery that creates an even more painful condition than the surgery was meant to treat. More commonly, the patient will have had a successful surgery and now several months or years later the pain is coming back.
Revision surgery is not always due to an error or mistake of a previous operation. Common reasons for revision surgery include such problems as pseudoarthrosis (failure to achieve solid fusion) which may be due to poor tissue healing. It is also important to consider that the spine is a living and dynamic structure. Even after apparent successful surgery the function and shape of the spine can deteriorate requiring further surgery to remedy a problem.
Revision surgery is a complex field and each patient must be evaluated and treated in a very individual manner to understand what is causing the problem and how best to address it.
Revision surgery can be more complicated than the original surgery because the normal spinal anatomy has already been altered. It may be more difficult to free nerve structures and place instrumentation if necessary. Additionally, the presence of scar tissue from a previous surgery can make the revision procedure technically more challenging. Finally, in the setting of revision surgery, it can be difficult to know exactly what the surgeon encountered during the first procedure and what precise steps were performed during that operation. It should also be noted that revision surgery can involve issues of re-balancing the spine and this is a much more challenging task when portions of the spine have been fused and are no longer mobile. In order to re-balance the spine in such a setting requires significant expertise when osteomies are necessary.
While there are special considerations for revision surgery, the important thing to consider is that the purpose of any spine surgery is to improve your chances for a productive and pain-free life. Our surgeons are experts in the special challenges posed by revision surgery.
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