Epidural Fibrosis and FBSS

Spine surgery is one of the most effective ways to eliminate chronic back pain. But it is still surgery, and surgery involves a lot of cuts into the body. It should come as no surprise that, after almost all spine surgeries, the body responds by creating scar tissue.

Scar tissue, known as epidural fibrosis, is a highly common side effect of surgery, including successful surgeries. In most cases, this scar tissue is completely benign. But for some patients, this scar tissue can cause post-operative pain, and for a small number of patients, that pain can be severe enough to require medical help. When scar tissue causes back or neck pain, it is called “Epidural Fibrosis.”

Introduction to Epidural Fibrosis Pain

Scar tissue has long been linked to failed back surgery syndrome (FBSS). Yet it should be noted that this link is controversial. Although scar tissue can produce back pain, scar tissue is not necessarily the cause of most forms of FBSS.

Since even successful spine surgery has scar tissue, the presence of scarring does not necessarily mean that it is responsible for pain after back surgery. Indeed, be careful about working with any surgeon that attributes back pain to scar tissue. Most other causes of back pain have to be ruled out first before any definitive diagnosis can be made.

But there are signs that epidural fibrosis is the cause of pain after back and neck surgery. If there is a lot of scar tissue and it forms around a nerve, the tissue can cause mild, moderate, and severe pain. Signs it may be epidural fibrosis include:

• Pain Develops Slowly – Scar tissue pain tends to develop slowly. That is because the tissues contract over time, and it is when they contract and “squeeze” a nerve that they cause pain. This often takes as long as 6 months or a year.
• Pain is Near Surgical Site – Pain can radiate, so pain may not necessarily be in the same place it was before. But often the pain occurs right in the same area as the initial surgery, which helps differentiate it from similarly slow-onset conditions, like adjacent segment disease.

Your surgeon should also perform tests to see if there is evidence of scar tissue and no signs of other possible diagnoses, such as broken hardware.

Treatment for Epidural Fibrosis

Led by renowned FBSS specialist Dr. James Chappuis, the team at Spine Center Atlanta helps both local and national patients that struggle with scar tissue receive an accurate diagnosis, and recommendations for treatment.

In some cases, epidural fibrosis can be treated without surgery. Doctors recommend stretching, and possibly physical therapy to reduce scar tissue pain. There are also minimally invasive procedures, such as laminectomies, that are successful at relieving epidural fibrosis.

If you have pain after back surgery and want a diagnosis or treatment, please call us at 404-620-5523. We can help you diagnose scar tissue/epidural fibrosis, and provide you with appropriate treatment recommendations led by our FBSS specialists.