Spine surgery is often seen as the final step in resolving chronic back pain—a last resort when conservative treatments fail. Yet for a significant number of patients, surgery doesn’t deliver the relief they hoped for. Instead, they find themselves still in pain, frustrated, and searching for answers. This all-too-common outcome is known in the medical world as Failed Back Surgery Syndrome (FBSS).
According to Jordan Sudberg, a leading pain management specialist, understanding why spine surgery fails is critical for patients, surgeons, and rehabilitation teams alike.
“Spine surgery is a powerful tool—but it’s not a cure-all,” Dr. Sudberg explains. “Too often, patients are rushed into procedures without fully addressing the root cause of their pain or managing their expectations.”
In this post, we explore what failed spine surgery really means, why it happens, and what Dr. Sudberg recommends to improve outcomes—and restore hope—for those still suffering after an operation.
What Is Failed Back Surgery Syndrome?
Failed Back Surgery Syndrome (FBSS) isn’t a specific diagnosis—it’s a general term used when persistent or recurring pain remains after one or more spinal surgeries. It can refer to pain in the back, neck, legs, or arms, depending on the type of surgery performed.
The symptoms may include:
- Continued low back pain
- Leg pain that was not relieved or worsened
- New areas of pain following surgery
- Reduced mobility or function
- Depression or emotional distress due to chronic pain
“The term ‘failed’ can be misleading,” says Dr. Sudberg. “It doesn’t always mean the surgeon did something wrong—it means the outcome didn’t match the goal, which is pain relief and improved function.”
How Common Is Failed Spine Surgery?
Statistics vary, but research suggests that up to 40% of spine surgeries fail to deliver satisfactory outcomes. Repeat surgeries carry an even higher risk of failure, with diminishing chances of long-term relief after each additional operation.
This has prompted many pain specialists—including Jordan Sudberg—to advocate for a multidisciplinary approach to spine care that goes beyond the operating room.
7 Most Common Causes of Failed Spine Surgery
Dr. Sudberg outlines several key reasons spine surgery may not produce the desired results:
1. Incorrect Diagnosis
Surgery can only address a problem if the problem is correctly identified. One of the most common issues Dr. Sudberg sees is misdiagnosis of the pain generator.
“Pain can come from discs, nerves, joints, or even muscles. If you operate on the wrong structure, the pain persists,” he explains.
Advanced diagnostics such as nerve blocks, imaging, and functional testing are critical in pinpointing the true source of the problem before surgery is even considered.
2. Inappropriate Candidate Selection
Not every patient is a good candidate for spine surgery. Factors such as psychological health, smoking, obesity, poor posture, or lack of physical conditioning can all reduce the likelihood of success.
“I’ve seen many patients who weren’t physically or emotionally prepared for surgery,” says Sudberg. “And that sets them up for disappointment.”
3. Scar Tissue Formation (Epidural Fibrosis)
Even when the surgery itself is performed correctly, scar tissue can develop around the nerves in the healing process. This scar tissue can cause compression and irritation, leading to recurring or new pain.
While some scar tissue formation is natural, excessive fibrosis is one of the most common causes of FBSS.
4. Hardware or Fusion Issues
In spinal fusion surgeries, implants and hardware (such as rods, screws, or cages) are used to stabilize the spine. But sometimes:
- The hardware loosens or breaks
- The bone fails to fuse properly (pseudoarthrosis)
- The hardware causes irritation to surrounding tissues
These complications often require revision surgery and can cause prolonged discomfort.
5. Adjacent Segment Disease (ASD)
After a fusion, the spinal levels above or below the fused area often take on more stress. Over time, this can lead to degeneration at those adjacent levels, resulting in new pain years after a successful initial surgery.
“You solve one problem and unintentionally create another,” Dr. Sudberg warns. “This is a known risk with fusions.”
6. Inadequate Postoperative Rehabilitation
Surgery is just one part of recovery. Without a structured rehabilitation plan that includes physical therapy, pain management, and core strengthening, the patient may never regain full function.
“Surgery without rehab is like fixing a car but never changing the oil again,” says Sudberg. “You’ll end up back in the shop.”
7. Unrealistic Expectations
Perhaps the most overlooked reason for failed surgery is misaligned expectations. Patients often believe surgery will result in immediate, complete pain relief—when in reality, recovery is gradual and varies from person to person.
Dr. Sudberg emphasizes education and honest discussions before surgery to prevent disappointment later.
What Can Be Done After a Failed Spine Surgery?
If you’ve had spine surgery and are still in pain, you’re not alone—and you’re not out of options. Dr. Sudberg specializes in post-surgical pain management, and his approach focuses on restoring function, reducing pain, and avoiding unnecessary repeat procedures.
Comprehensive Evaluation
The first step is determining why the pain persists. This may involve:
- MRI or CT scans
- Nerve conduction studies
- Diagnostic injections
- Pain mapping
Multimodal Pain Management
Dr. Sudberg builds custom treatment plans using a combination of:
- Targeted physical therapy
- Epidural steroid injections
- Spinal cord stimulation
- Radiofrequency ablation
- Regenerative therapies (e.g., PRP or stem cell therapy)
“Many patients can regain control of their lives without another surgery,” he says. “We work to calm the pain, strengthen the body, and give them real tools for moving forward.”
Psychological Support
Chronic pain takes a toll on mental health. Therapy, mindfulness, and behavioral coaching are often part of a comprehensive recovery plan.
“The brain and body are linked—healing one means supporting both,” Dr. Sudberg explains.
Final Thoughts: Hope Beyond the Operating Room
Failed spine surgery can feel like a devastating setback. But as Jordan Sudberg reminds his patients, pain does not mean defeat.
“The answer isn’t always more surgery. Often, it’s about stepping back, understanding what went wrong, and creating a new path forward with the right team.”
With the right pain management specialist, tools, and mindset, even those who’ve struggled for years can find meaningful relief and regain control of their lives.
