Back in the 1970s, Dr. Rosomoff, medical director of the Comprehensive Pain and Rehabilitation Center at the University of Miami School of Medicine, did a lot of back surgery. The professor and chairman emeritus in the department of neurological surgery and professor in the departments of anesthesiology and orthopedics and rehabilitation at the University of Miami believed his patients were improving dramatically because of the surgery. But he found out that wasn t the case when he started patients on an intensive pre-surgical rehabilitation program. He realized that after two weeks of rehab, patients no longer had indications for surgery. That s when he called the moratorium on surgery, telling patients they d have to go through rehab before he d operate.
Backs don t fail.
He argued that the reason for failed back syndrome, defined by some as persistent pain after surgery or other interventions, often happen because initial patient evaluations are not complete. The source of the pain in most cases is not from the spine and surrounding nerves but rather from the muscles, tendons and ligaments that support the anatomy, he said. Lynn Johnson, MD, was the moderator for the AAPM session. He said that failed back syndrome can occur in as many as 10 to 40 percent of patients who get some type of lumbar spine surgery. Dr. Johnson is board certified in anesthesia and pain medicine and director of the Center for Pain Medicine of North Carolina, which is affiliated with East Carolina University School of Medicine in Greenville, North Carolina.