Revision Spinal Surgery
What is Revision Spinal Surgery?
Revision spinal surgery is a procedure that takes place on a patient who has already undergone some form of spine surgery. Typically, by three months after a surgery has been completed, any lingering pain is gone. When a patient is still reporting chronic pain beyond this time frame, revision spinal surgery is sometimes considered.
In other instances, factors besides pain can necessitate revision spinal surgery. These may include the removal of scar tissue that has developed around the incision or an improper diagnosis by a previous physician. At times the procedure is warranted because an earlier surgery did not correct the existing problem.
Revision spinal surgery may also be related to the reherniation of a disc, infection, hardware failure, non-surgery related spine degeneration, flat back syndrome, instability, adjacent segment degeneration or pseudarthrosis (failure to achieve solid fusion).
Fusion failure is a relatively common problem that results in a need for revision spinal surgery. Although spinal fusion is performed to successfully treat chronic back pain caused by a number of different causes, sometimes these procedures are unsuccessful. Fusion failure may occur as a result of hardware problems, new spine issues just above or below where the fusion was performed or recurrent conditions such as spinal stenosis or spinal instability.
Revision surgical fusion involves implanting a new bone graft to the affected area, as well as a bone growth stimulator to promote bone formation in some cases. Previous instrumentation placed within the spine may be removed during this procedure to allow for placement of a new graft and to help the bone properly heal.
The decision to undergo revision surgery depends on the diagnosis made after the initial failure. In many cases, the cause of fusion failure is unknown, which can further complicate the decision to undergo revision surgery. Revision fusion surgery is a much more complicated procedure than initial fusion surgery and carries more risks for patients, including tissues not healing well and a higher risk of infection. The decision to undergo this procedure should always be fully discussed between patient and doctor in order to decide what is best for each individual case. At Princeton Neurological Surgery, Dr. Lipani often corrects patients who’ve suffered failed spine surgery at other institutions and his patient outcomes statistically exceed the national average.