Causes and Diagnoses

Causes and Diagnoses of Failed Back Surgery Syndrome

There are several reasons people may continue to have pain following back surgery:

  • Failure of the spine to fuse
  • Failure of a spinal implant
  • Recurrent disc herniation
  • Continued nerve compression
  • Nerve damage present before surgery that does not resolve afterwards
  • Pain from another region of the spine
  • Failure to operate on the lesion causing the pain


Before physicians will state that back surgery has “failed,” tests are done to make sure that no further back surgery is required. These tests may include:

  • MRI scans or myelograms (CT scans with dye injected into the spinal fluid) to look for continued nerve compression or herniated discs
  • CT scans to make sure that bones have fused and have not fractured
  • X-rays to check the spinal alignment and make sure spinal fixation hardware has not loosened or broken
  • Electromyography (EMG) to look at nerve function
  • Nuclear medicine bone scans to rule out infection

Diagnostic Tests