There are lots of misconceptions and lack of understanding about spine problems. This is primarily because of lack of complete knowledge and proper counseling of the patients regarding spine related problems. People fear for spine surgery, not only because they feel it can cause problem during surgery, but they also feel that spine surgery can cause future problems also.
A prolapsed disc or spinal stenosis is usually associated with disc degeneration and facet arthritis. In fact, degeneration is the reason behind these pathologies. Spine decompression surgery provides relief from current nerve pressure related symptoms. However, degeneration of disc, facet joints and spine ligaments continues due to ongoing movements of spine with day to day activities. This progressive degeneration can cause recurrence of disc prolapse or spinal stenosis at previously operated level, causing nerve pressure symptoms. Continued degeneration can also cause local spinal pain due to spondylosis.
Patients with spinal instrumentation lose movement at operated level. This leads to increased pressure on adjacent upper and lower level. It’s called accelerated Adjacent Segment Degeneration (ASD). This might lead to symptoms of stenosis or spondylosis. Multiple instrumentation for a deformity correction or complex spine reconstruction will have more chance to develop ASD. Instrumentation may fail if the fusion does not take place. This causes either loosening or broken implant, which might need a repeat spine surgery if it is causing symptoms.
A new pathology at a distant level is an independent entity with no relationship with primary pathology. Unfortunately, these new problems can cause same type of symptoms which patient had before their primary surgery. This leads to patient thinking that their earlier surgery has failed.
Even for these recurrent spine problem, effective treatments are available. A step by step is used as in a primary spine pathology. A revision surgery, if required, gives almost as predictable results as primary surgery.