Failed Back Surgery SYNDROME and Prolotherapy
 

Patients often have chronic low back pain persisting after surgery and are put into the category of people with "failed back surgery syndrome." It is easy to find reasons why a back surgery patient would still have pain after the surgery. During surgery, for example, a discectomy (removal of the disc), the surgeon must spread some muscles and cut some of the ligaments in order to perform the surgery. The surgery itself can cause ligamentous laxity and instability of the spine.

Another reason for chronic low back pain after surgery is that another segment of the spine is now unstable and degenerated. This is very common after spinal fusion. The segments above and below the fused area have to move more to compensate for the fusion. Eventually these areas become unstable. This applies for the areas above and below a laminectomy and discectomy. With the disc or lamina gone, after surgery the vertebrae above and below the surgery site must take more of the load. Eventually these areas become degenerated and unstable and are the source of chronic low back pain. In these cases, Prolotherapy to the correct the instability will help strengthen the segments and relieve the low back pain.

Most people do not realize how much tissue is removed with surgery. A laminectomy site heals with scar tissue, not with bone. How strong do you think scar tissue is compared to bone? This often results in instability at the level of surgery, therefore leading to an increased rate of degeneration in this area. Osteoarthritis will develop faster when instability is present. This is why the segments above and below the surgery site are degenerated.

The main point to remember is that surgery involves the removal of bone, ligaments, and tendons, and Prolotherapy involves the repair and growth of these structures. The long-term prognosis is much better if Prolotherapy is performed, in addition to surgery, so instability does not develop. Surgery of the spine should be considered only after all conservative treatments have been explored and failed. This includes Prolotherapy. If Prolotherapy was used as often as it should be, a great many of the operations done on the lower back would be eliminated.

Another reason pain may not be alleviated with surgery is that the surgery did not address all of the causes of the back pain. Most surgeons do not know that the ligaments in the back refer pain down the leg. Not

 everyone with sciatica has a disc problem. This is the number one reason why back surgery (see also Prolotherapy and Back Surgery) for sciatica does not cure the problem, because it does not address the sacroiliac, sacrotuberus (sacrotuberous), sacrospinus (sacrospinous), or iliolumbar ligament laxity that was causing the pain. Often a herniated disc and ligament laxity occur together. As early as 1977, Dr. R. Barbor (Sclerosant Therapy. Reunion Sobre Patologia de la Calumna Vertebral. Murcia, Spain, March 30, 1977) reported that ligament laxity and disc problems occur together in 80 percent of the cases. In such cases, surgery alone does not provide complete pain relief. It is relatively common for a patient to continue to have low back pain after disc surgery. The bulging disc, in such an instance, was not the only cause of the pain because the area was not unstable. In this case the person also needed Prolotherapy, in addition to surgery.