Why Back Surgery Side Effects Are so Common: BFH Syndrome

by Chris Centeno, MD /

Receive a Regenexx® Patient Info Packet by email and learn why it's a superior regenerative solution.

I write about what I see in clinic and around me. One of the interesting things from this week was a low back pain patient who had surgery that was so invasive it left a hole in his low back. I coined the term BFH syndrome (Big [Insert Expletive] Hole) to describe this back surgery side effect. Let me explain.

What Is a Laminectomy/Discectomy?

Back surgery is often performed when there is a bulging disc that’s pressing on a nerve. The surgeon will remove a part of the disc (discectomy) and then sometimes, to give the nerve more room, the lamina (laminectomy). The lamina is the bony back part of the spinal canal.

Why Does Back Surgery Have Such a Bad Rep?

Just about everyone knows someone or knows of someone who has had a back surgery disaster. Hence, back surgery side effects are up close and personal. In the case above, while removing the disc to take pressure off a nerve can help reduce nerve pain in the short run, it weakens the structure of the disc and makes it more likely to fail (recurrent disc herniation). In addition, while taking out the back wall of the spinal canal may seem like a good idea at the time as it gives the nerve more room, critical stabilizing muscles that attach there are usually destroyed. Since these muscles protect the disc, facet joints, and nerves, removing them just means more problems down the road. Basically, a short-term solution turns into back surgery side effects.

BFH Syndrome

Most people have no idea that spinal surgery is damage to accomplish a goal. Meaning, I look at MRIs all day that show the serious damage done by back surgery. In this patient’s case, a “hole” where critical tissues should be. Let’s dive deeper into what caused this void.

The images above show the issue. On the left-hand side, you see a side image of the spine. Note that the yellow-dashed line represents the hole caused by surgery. You can easily see dark bones and muscles above and below the hole, but that area looks white. Now, look at the image on the right. This is a view looking down on the tissues (axial or “saw you in half” view). The yellow-dashed line again outlines the hole. You see the dark low back muscles surrounding the white void. In fact, the hole is exactly where the critical stabilizer of the low back, called the multifidus, should live. Meaning, at this level that muscle has been obliterated, causing serious back surgery side effects.

Why is the multifidus critical? See my video below for more information:

Why did the surgeon leave a hole? He placed retractors to open up a tunnel from the skin to the lamina, which he then removed. By removing the muscles and bone in the way, he yanked out the multifidus.

Is the Hole a Problem?

Yep, without the critical multifidus stabilizer, this level (and now the one below it) are unstable. The patient has chronic low back pain because the tissues that are normally protected by the multifidus are getting beat up. Also realize that while I can help heal some of the damage and reduce the nerve irritation using precise orthobiologic injections, I can’t fill the hole.

How You Can Avoid a BFH

Regrettably, the term “minimally invasive” in spine surgery is often more of a marketing tool than based in reality. Pretty much all of the surgeons who claim to be able to perform minimally invasive spine surgery leave a BFH or an SMH. However, there are a handful of surgeons around the country who do perform true minimally invasive low back surgery, which is done through a portal the size of a ballpoint pen, and this type of procedure will spare the critical stabilizing muscles.

In addition, the best way to avoid a BFH is to avoid the surgery altogether. In 90+% of our patients with these issues, we treat them with precise X-ray–guided platelet and stem cell injection or platelet procedures. However, please be wary of con artists offering “stem cell” injections for back pain, which more often than not take these forms:

  1. A nurse in a chiropractor’s office injecting dead amniotic or umbilical cord tissue blindly into the back muscles. See my video for info on this scam: 
  2. A plastic surgeon or orthopedic surgeon who uses fat stem cells and starts an IV claiming that the stem cells will magically find their way to the site and also performs blind low back muscle injections.
  3. A pain management doctor offering dead amniotic or umbilical cord tissue injections using X-ray guidance. Why do I say this is dead tissue? Because we took the time and spent the money to do the research that these doctors don’t have the ability to do. See my video below for more information: 

The upshot? Avoid having a big hole carved in your low back. One way to do this is to skip the surgery by getting precise, real stem cell injections. In addition, many patients do just as well with advanced platelet procedures. Finally, if all of that fails, find that very rare surgeon to whom the term “minimally invasive” is more than a marketing sales tool.

Leave a Reply

Your email address will not be published. Required fields are marked *

12 thoughts on “Why Back Surgery Side Effects Are so Common: BFH Syndrome

  1. JUNE HUCHINGSON PhD

    ON YOUR BEN GREENFIELD VIDEO.
    I WAS GOING TO WATCH THE NEW SERIES ON STEM CELLS BUT I DIDN’T BECAUSE YOU THOUGHT IT WAS AN UNRELIABLE SERIES.
    I GOT CAUGHT AT SOMEONES HOUSE AND WATCHED ONE OF THE LAST OF THE SERIES ABOUT DR. TAMI MERAGLIA, MD. WHO WAS CALLED A STEM CELL SPECIALIST IN WASHINGTON STATE. SHE USES A HOLISTIC APPROACH. SHE HAS DONE RESEARCH ON 5000 PATIENTS. SHE DOES IVs OF STEM CELLS … AND CLAIMS THEY GO TO WHERE THEY HAVE TO GO. DID YOU WATCH THE SERIES? A LOT OF PEOPLE THINK STEM CELLS GO WHERE THEY ARE NEEDED. DOES IT WORK SOMETIMES? PLACEBO EFFECT?

  2. Pamela R. Glaubach

    I had disc 3 removed and [email protected] fusion and a lamenectomey. Leaving me with great discomfort in the middle of my back feeling like a piece of wood has splintered and is sticking me in the back. Plus my left si joint has not responded yet from Pt. After this back surgery. Now because of this pain situation another si fusion is being scheduled. Help

    1. Regenexx Team

      It would be wonderful if fusion or disc replacement were reversible, but unfortunately they’re not. We can usually help with Adjacent segment disease. The ASD in an L4/L5 Fusion would likely affect the SI joint. Please see: https://regenexx.com/blog/pain-after-back-fusion-adjacent-segment-disease/ If you’d like to see if you’d be a Candidate, please submit the Candidate form so we can take a look.

  3. Ted Martin

    So how does one find “that very rare surgeon to whom the term “minimally invasive” is more than a marketing sales tool” ?

    1. Regenexx Team

      Ted,
      That’s a good question…

  4. Jennifer Woodward

    What will happen to the man who’s too far gone for you to help?

    1. Regenexx Team

      Jennifer,
      As I said, while I can help heal some of the damage and reduce the nerve irritation using precise orthobiologic injections, I can’t fill the hole. The lack of the multifidus will leave the area unstable.

  5. Chad Freeman

    I avoided back surgery in March with a Platelet Lysate injection, it has helped a lot. I have gotten some of my life back. I had a constantly tightening calf due to S5L1 nerve root irritation.

    Thanks to Regenexx

    1. Chris Centeno Post author

      Thanks, Chad for the feedback. Yes, I can also personally attest to how platelet lysate epidurals have changed my life as well.

  6. Gerald ONeill

    I know you would probably want an MRI of my back before assessing whether I would be a good fit. I have two artificial hips, is an MRI of the back even an option for me? I have X-Rays.

    1. Regenexx Team

      Hi Gerald,
      We’d need more information. What type of Hip device. When were they done?

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
View Profile

Get Blog Updates by Email

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
Select Your Problem Area
Shoulder

Shoulder

Many Shoulder and Rotator Cuff injuries are good candidates for regenerative treatments. Before considering shoulder arthroscopy or shoulder replacement, consider an evaluation of your condition with a regenerative treatment specialist.

  • Rotator Cuff Tears and Tendinitis
  • Shoulder Instability
  • SLAP Tear / Labral Tears
  • Shoulder Arthritis
  • Other Degenerative Conditions & Overuse Injuries
Learn More
Cervical Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Knee

Knees

Knees are the target of many common sports injuries. Sadly, they are also the target of a number of surgeries that research has frequently shown to be ineffective or minimally effective. Knee arthritis can also be a common cause for aging athletes to abandon the sports and activities they love. Regenerative procedures can be used to treat a wide range of knee injuries and conditions. They can even be used to reduce pain and delay knee replacement for more severe arthritis.

  • Knee Meniscus Tears
  • Knee ACL Tears
  • Knee Instability
  • Knee Osteoarthritis
  • Other Knee Ligaments / Tendons & Overuse Injuries
  • And more
Learn More
Lower Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Hand & Wrist

Hand & Wrist

Hand and wrist injuries and arthritis, carpal tunnel syndrome, and conditions relating to overuse of the thumb, are good candidates for regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Hand and Wrist Arthritis
  • Carpal Tunnel Syndrome
  • Trigger Finger
  • Thumb Arthritis (Basal Joint, CMC, Gamer’s Thumb, Texting Thumb)
  • Other conditions that cause pain
Learn More
Elbow

Elbow

Most injuries of the elbow’s tendons and ligaments, as well as arthritis, can be treated non-surgically with regenerative procedures.

  • Golfer’s elbow & Tennis elbow
  • Arthritis
  • Ulnar collateral ligament wear (common in baseball pitchers)
  • And more
Learn More
Hip

Hip

Hip injuries and degenerative conditions become more common with age. Do to the nature of the joint, it’s not quite as easy to injure as a knee, but it can take a beating and pain often develops over time. Whether a hip condition is acute or degenerative, regenerative procedures can help reduce pain and may help heal injured tissue, without the complications of invasive surgical hip procedures.

  • Labral Tear
  • Hip Arthritis
  • Hip Bursitis
  • Hip Sprain, Tendonitis or Inflammation
  • Hip Instability
Learn More
Foot & Ankle

Foot & Ankle

Foot and ankle injuries are common in athletes. These injuries can often benefit from non-surgical regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Ankle Arthritis
  • Plantar fasciitis
  • Ligament sprains or tears
  • Other conditions that cause pain
Learn More

Is Regenexx Right For You?

Request a free Regenexx Info Packet

REGENEXX WEBINARS

Learn about the #1 Stem Cell & Platelet Procedures for treating arthritis, common joint injuries & spine pain.

Join a Webinar

RECEIVE BLOG ARTICLES BY EMAIL

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Subscribe to the Blog

FOLLOW US

Copyright © Regenexx 2019. All rights reserved. | Privacy Policy

*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.

Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.