Pain After Back Surgery: Tracy’s Story
Can we help failed back surgery patients? That’s one of the most common questions I get from patients with chronic back pain. The answer is often “yes” and today I’ll cover Tracy’s journey with the DDD procedure. Let’s dig in.
Failed Low Back Syndrome
One of my favorite movie quotes of all time comes from a B-rated film called “Broken Arrow”. It’s about a US nuclear weapon gine missing, and the exchange between the characters goes like this:
“- Giles Prentice: A Broken what?
– Secretary of Defense Baird: Broken Arrow. It’s a Class 4 Strategic Theatre Emergency. It’s what we call it when we lose a nuclear weapon.
– Giles Prentice: I don’t know what’s scarier, losing nuclear weapons, or that it happens so often there’s actually a term for it.”
That’s how I feel about the term “Failed Low Back Syndrome”, which means a patient that underwent surgery is no better to far worse. This happens so often that there’s actually a medical term for it. That’s Tracy’s story in a nutshell.
Tracy’s back and leg pain/weakness nightmare started in May 2000 when she was bucked off a horse causing a disc herniation at L4-5. She ultimately underwent an L4-5 Microdiscectomy surgery and 5 months later a second L3-4 Microdiscectomy. When the pain came back, years later, she then had her third surgery which was a bigger Hemilaminectomy.
However, despite three back surgeries, when her low back pain didn’t go away, the surgeon ordered another MRI which showed a disc fragment around the nerve which had created scar tissue. She also had new symptoms of vaginal burning after the final surgery and radiating pain down her legs with occasional numbness and tingling down her left leg, tightness in her lower back muscles, and weakness in her left leg with prolonged sitting or walking. When I first performed an exam in the summer of 2020, her symptoms were gradually getting worse.
This is her MRI image:
In the middle image, we see the hole in the lamina bone created by the surgeon (the roof of the spinal canal). In the image above on the right, we see the damage to the stabilizing muscles on the patient’s left side (which is on the right of this image). Notice the nice dark muscle on the left of that image and all-white (lack of normal muscle) on the right of the image.
Treating Tracy with our Platelet based DDD Procedure
Tracy had two platelet-based DDD procedures. What’s that? To find out more, watch my video below:
How did she do? Tracy loves to walk with friends. Before the procedure, she would get to about 1/4 mile mark and her leg would go weak. This was pretty scary for her as if she wandered any distance from her home, she feared she wouldn’t make it back unassisted. Now she’s up to 4 miles of daily walking and her leg doesn’t give out. Another big change is that before the procedures, she would need to bring a TENS unit with her if she was going to ride in a car or sit for any length of time. Now she can sit and ride in the car without issues. So after two procedures, she’s doing very well and on a telemedicine follow-up yesterday, we decided to stop here for now.
What Would Have Been the Next Step if Tracy Stayed with the Usual Treatments?
The first one is obvious, someone would have offered her a fourth surgery which would have been a multi-level fusion. Yet another surgical possibility would have been inserting multiple disc replacement devices. All HUGE surgeries with HUGE potential complications!
If she didn’t go that surgical route, then Radiofrequency Ablation where the nerves carrying pain signals are destroyed would be one option. Then you have implantable stimulators to control the pain. If all of that didn’t work, then the only option would have been an implantable spinal pain pump.
The upshot? Continuing to get more and more surgeries to correct the results of the last one is like being a gambler in Vegas who just can’t stop making the next bet. When surgery doesn’t work, consider something else. Tracy finally broke that cycle. For many patients that we treat with pain after back surgery, the platelet DDD procedure gets them back to what they like to do!