The Link Between Arachnoiditis and Failed Back Surgery Syndrome

Arachnoiditis often plays a significant role in the development of Failed Back Surgery Syndrome (FBSS). In fact, it ranks among the leading causes of FBSS, trailing only behind a select few other factors. This condition, marked by inflammation of the arachnoid membrane surrounding spinal nerves, can develop after spinal surgery—especially when nerve roots are disturbed or exposed to irritation. As a result, individuals who develop arachnoiditis postoperatively may experience persistent, sometimes severe pain, which ultimately contributes to the ongoing symptoms seen in FBSS. Back Surgery

At Big Apple Spine & Orthopedics, Dr. Arutyunyan specializes in addressing failed back surgery syndrome (FBSS), a condition where patients experience chronic back or neck pain following an unsuccessful spinal surgery. This syndrome encompasses various reasons for surgical failure, including issues like disc herniation, continuous nerve compression, unsuccessful fusion, or hardware complications, among others. Dr. Arutyunyan and his team understand the frustration and discomfort associated with FBSS and they offer personalized solutions to alleviate pain and improve your quality of life.

Symptoms of FBSS can manifest in sharp, severe, or stabbing pain during movement, chronic pain in the back or neck, limited mobility, and dependence on prescription pain medication. Recognizing these symptoms is crucial in guiding treatment decisions and achieving successful outcomes. Dr. Arutyunyan emphasizes the importance of thorough evaluation and shared decision-making in addressing FBSS, ensuring that patients actively participate in their care journey.

The Role of Diagnostic Injections and Discography

To further refine the diagnosis of FBSS, Dr. Arutyunyan may recommend diagnostic injections or discography as part of a comprehensive evaluation. These minimally invasive procedures help pinpoint the sources of persistent pain by targeting specific structures in the spine.

• Diagnostic injections: These targeted injections, such as anesthetic or steroid injections, can confirm whether pain originates from certain joints (like the facet or sacroiliac joints) or from irritated nerve roots. A positive response often provides not only immediate relief but also valuable information about the exact cause of symptoms.
• Discography: When there’s suspicion that a spinal disc is contributing to ongoing pain, discography can be particularly useful. During this procedure, a contrast dye is injected into the disc under X-ray guidance; patient feedback during the injection, combined with imaging and the results of other diagnostic tests, helps confirm if that disc is a significant pain generator.

By integrating these techniques with patient history, physical examination, and advanced imaging, Dr. Arutyunyan ensures a precise and individualized care plan for each patient facing FBSS. comprehensive

How Can Failed Back Surgery Syndrome Be Prevented?

Preventing FBSS starts long before a patient even enters the operating room. Dr. Arutyunyan emphasizes a proactive, team-based approach aimed at minimizing risks and setting the stage for successful surgical outcomes. Here are several key strategies his team uses to help keep FBSS at bay:

1. Clear Communication and Realistic Expectations
   A cornerstone of prevention is ensuring you understand exactly what surgery can—and cannot—achieve. Dr. Arutyunyaninvests time in patient education, providing honest insights about the risks, benefits, and expected recovery timeline. Managing expectations helps you make informed decisions and avoid post-surgical disappointment.
2. Comprehensive Pre-Surgical Evaluation
   Every patient at Big Apple Spine & Orthopedicsreceives an in-depth preoperative assessment. This includes a review of your complete medical history, imaging studies, and a discussion of any underlying health issues such as diabetes or osteoporosis that could affect surgical success. Identifying these factors early allows for a more tailored surgical plan.
3. Addressing Psychological and Social Factors
   It’s no secret that stress, anxiety, or depression can influence pain and recovery. Dr. Arutyunyanoften works closely with other specialists, such as psychologists or pain management experts, to ensure that emotional and social stressors are addressed before surgery.
4. Advanced Surgical Techniques and Technology
   A meticulous approach in the operating room is essential. Dr. Arutyunyanutilizes cutting-edge surgical methods, such as minimally invasive procedures and neuronavigation, to reduce tissue trauma, minimize complications, and ensure the most precise results possible.
5. Multidisciplinary Collaboration
   Preventing FBSS isn’t a solo effort. The team collaborates with primary care physicians, physical therapists, and pain specialists to optimize pre- and post-operative care, making adjustments as needed for each patient’s unique circumstances.

By focusing on these preventive strategies, Dr. Arutyunyan aims to reduce the likelihood of FBSS and give every patient the best chance for relief and recovery.

A thorough and personalized approach, paired with open communication, goes a long way toward preventing complications and improving surgical outcomes. assessment of the patient’s medical history, symptoms, and previous surgical interventions. Dr. Arutyunyan and his team conduct a detailed physical examination and may order imaging tests such as X-rays, CT scans, or MRI scans to evaluate the extent of surgical complications and identify underlying issues contributing to the patient’s pain. This holistic approach allows for accurate diagnosis and tailored treatment planning.

Treatment options

Measuring Progress with Outcome Measures

Assessing progress after rehabilitation is an essential part of a successful recovery journey. Dr. Arutyunyan relies on well-established outcome measures—such as patient-reported pain scales, functional assessment tools, and mobility tests—to objectively track improvements over time. These measures help capture a clear picture of how symptoms evolve, whether daily activities become easier, and if overall well-being is improving.

For example, tools like the Oswestry Disability Index or the Visual Analog Scale for pain allow both patients and the care team to gauge where meaningful changes are happening. Routine use of these standardized assessments not only helps fine-tune treatment plans but also empowers patients to see tangible results, ensuring therapies are effectively targeting their individual needs. for FBSS focus

Exercise Recommendations After Spinal Surgery

A well-rounded exercise plan is often an essential part of recovering from spinal surgery, especially for patients experiencing FBSS. Dr. Arutyunyan encourages incorporating safe and enjoyable activities that can help restore strength, mobility, and confidence.

Some common recommendations include:

• Walking: As a low-impact aerobic activity, walking is an accessible way to boost overall activity levels and promote circulation without putting undue strain on your back.
• Sit-to-Stand Exercises: Repeatedly moving from sitting to standing helps strengthen the lower limbs. For patients with weakness or symptoms that affect one leg more than the other, this exercise can be modified to target the weaker side.
• Core and Back Strengthening: Controlled movements like deadlifts (performed with proper guidance) can help rebuild spinal erector strength—a key muscle group that may be weakened after surgery. Incorporating exercises such as woodchops introduces gentle spinal movement, which not only engages core muscles but can also help alleviate fear of movement over time.
• Balance and Stability Drills: Using a wobble board or similar equipment, patients can practice standing or even gentle squats to challenge postural control. These drills can be a fun way to improve stability and confidence during daily movements.
• Functional Marches: Exercises like suitcase marches—carrying a light weight in one hand while marching in place—can further develop core stability and balance, especially in the later stages of rehabilitation.

It is important to emphasize that all exercises should be tailored to your specific abilities and stage of recovery. Dr. Arutyunyan and his team work closely with each patient, often partnering with licensed physical therapists, to ensure your rehabilitation program is both safe and effective. Always consult with your care team before beginning any new exercise routine after spinal surgery. on relieving pain, improving function, and restoring mobility. Dr. Arutyunyan employs a multidisciplinary approach that may include physical therapy, medication management, interventional procedures, and lifestyle modifications. By involving patients in the decision-making process, Dr. Arutyunyan ensures that treatment plans align with their individual goals and preferences, promoting greater satisfaction and adherence to therapy.

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Benefits and Limitations of Surgery for Spinal Conditions

Surgical intervention for spinal conditions can significantly reduce pain, particularly pain that radiates down the legs, and often leads to improved function and a better quality of life for many patients. While these are notable benefits, it’s important to recognize that surgery may not completely resolve every symptom. Some individuals may continue to experience discomfort or limitations even after a technically successful procedure.

After surgery, Dr. Arutyunyan encourages patients to stay as active as their pain allows, as minimizing inactivity can help support the recovery process. Typically, more structured physical therapy becomes appropriate around two months post-operatively, allowing for a gradual return to daily activities and targeted rehabilitation.

Although research continues to explore the best post-surgery rehabilitation strategies, evidence consistently highlights the importance of strength training and active rehabilitation. These approaches often enhance the overall outcome, helping patients regain strength and mobility more effectively. However, it’s worth noting that individual responses can vary, and recovery timelines may differ from patient to patient. conservative treatments fail to provide adequate relief, surgery may be considered to address the underlying issues contributing to FBSS. Dr. Arutyunyan offers various surgical interventions tailored to each patient’s specific needs, such as revision spinal fusion, decompression procedures, or hardware removal. Through open communication and shared decision-making, Dr. Arutyunyan collaborates with patients to determine the most appropriate surgical approach based on their unique circumstances.

At Big Apple Spine & Orthopedics, the philosophy of direct management by an expert spine surgeon like Dr. Arutyunyan underscores the commitment to personalized and compassionate care. By prioritizing patient involvement and empowerment, the practice strives to deliver optimal outcomes and improve patients’ overall well-being. Patients experiencing symptoms of FBSS are encouraged to schedule a consultation with Dr. Arutyunyan to explore treatment options and embark on the path to recovery.

At Big Apple Spine & Orthopedics, Dr. Arutyunyan specializes in addressing failed back surgery syndrome (FBSS), a condition where patients experience chronic back or neck pain following an unsuccessful spinal surgery. This syndrome encompasses various reasons for surgical failure, including issues like disc herniation, continuous nerve compression, unsuccessful fusion, or hardware complications, among others. Dr. Arutyunyan and his team understand the frustration and discomfort associated with FBSS and they offer personalized solutions to alleviate pain and improve your quality of life.

Symptoms of FBSS can manifest in sharp, severe, or stabbing pain during movement, chronic pain in the back or neck, limited mobility, and dependence on prescription pain medication. Recognizing these symptoms is crucial in guiding treatment decisions and achieving successful outcomes. Dr. Arutyunyan emphasizes the importance of thorough evaluation and shared decision-making in addressing FBSS, ensuring that patients actively participate in their care journey.

Diagnosing FBSS involves a comprehensive assessment of the patient’s medical history, symptoms, and previous surgical interventions. Dr. Arutyunyan and his team conduct a detailed physical examination and may order imaging tests such as X-rays, CT scans, or MRI scans to evaluate the extent of surgical complications and identify underlying issues contributing to the patient’s pain. This holistic approach allows for accurate diagnosis and tailored treatment planning.

Treatment options for FBSS focus on relieving pain, improving function, and restoring mobility. Dr. Arutyunyan employs a multidisciplinary approach that may include physical therapy, medication management, interventional procedures, and lifestyle modifications. By involving patients in the decision-making process, Dr. Arutyunyan ensures that treatment plans align with their individual goals and preferences, promoting greater satisfaction and adherence to therapy.

In cases where conservative treatments fail to provide adequate relief, surgery may be considered to address the underlying issues contributing to FBSS. Dr. Arutyunyan offers various surgical interventions tailored to each patient’s specific needs, such as revision spinal fusion, decompression procedures, or hardware removal. Through open communication and shared decision-making, Dr. Arutyunyan collaborates with patients to determine the most appropriate surgical approach based on their unique circumstances.

At Big Apple Spine & Orthopedics, the philosophy of direct management by an expert spine surgeon like Dr. Arutyunyan underscores the commitment to personalized and compassionate care. By prioritizing patient involvement and empowerment, the practice strives to deliver optimal outcomes and improve patients’ overall well-being. Patients experiencing symptoms of FBSS are encouraged to schedule a consultation with Dr. Arutyunyan to explore treatment options and embark on the path to recovery.

Shared Decision Making

At Big Apple Spine & Orthopedics, we are committed to providing total quality care to our patients through our dedication to the practice of shared decision making. This medical concept involves active collaboration between patients and healthcare professionals in making healthcare decisions that align with the patient’s values, preferences, and individual circumstances. We understand that each patient is unique, and their perspective is integral to crafting personalized treatment plans that prioritize their well-being and satisfaction.