Out-of-state? Free MRI review + telehealth consult before you travel4.9 ★ · 619 Google reviewsBoard-certified — American Board of Orthopaedic SurgeryMinimally invasive, same-day spine surgery in Beverly HillsCall (424) 217-7463
Out-of-state? Free MRI review + telehealth consult before you travel4.9 ★ · 619 Google reviewsBoard-certified — American Board of Orthopaedic SurgeryMinimally invasive, same-day spine surgery in Beverly HillsCall (424) 217-7463
Pain that lingers or returns after spine surgery isn't the end of the road — it's a signal to find the true source, and it's exactly the problem many patients come to Dr. Melamed to solve.
Failed back surgery syndrome is the term for ongoing back or leg pain that continues, returns, or newly appears after a spine operation. The name is unkind — it doesn't mean the surgeon failed or that nothing can be done. It usually means the original procedure didn't fully address the source of the pain, treated the wrong level, or created a new problem nearby.
Patients in this situation are often exhausted and discouraged, having been told their imaging looks acceptable while their pain says otherwise. A large part of Dr. Melamed's practice is built around exactly these cases: taking a fresh, honest look, questioning the original plan, and finding what is actually driving the pain before recommending anything further.
If you’ve had spine surgery in the past, you may have heard about “failed back surgery syndrome”. Failed back surgery syndrome is a term for the chronic (long-term) back and leg pain problems that some people experience after spine surgery. Experts estimate that failed back surgery syndrome affects up to 20% of people who have had spinal surgery, and its symptoms can range from mild to severe and life-altering.
Failed back surgery syndrome is a general term for new, persistent, or recurrent back or leg pain that occurs more than 6 months after spine surgery. A failed back surgery syndrome diagnosis requires that:
The pain is at the same (or nearly the same) vertebral level as the surgery
Imaging and exams don’t show any abnormality that would account for the pain
You don’t have any other abnormalities that would require another spine surgery
Failed back surgery syndrome is sometimes called other names, such as “postlaminectomy syndrome,” “chronic postoperative pain,” or, more recently, “persistent spinal pain syndrome”.
✓Back or leg pain that persists after surgery was supposed to fix it
✓Pain that improved briefly, then returned
✓New pain at a level next to the previous surgery
✓Numbness, tingling, or weakness that never fully resolved
✓Reduced mobility and reliance on pain medication
✓A sense that the original problem was never truly addressed
Failed back surgery syndrome can be difficult to distinguish from other causes of back pain, and its symptoms may vary based on the cause of the pain. Other symptoms of failed back surgery syndrome include:
Pain at or near the same level as the previous surgery
Muscle weakness or loss of function
Difficulty walking
Depression or anxiety
Causes of Failed Back Surgery Syndrome
The original pain source was misidentified or at the wrong level
Recurrent disc herniation at the operated level
Scar tissue forming around a nerve root
Adjacent-segment breakdown next to a prior fusion
Incomplete decompression that left a nerve still crowded
Hardware irritation or a joint that was overlooked, such as the SI joint
Failed Back Surgery Syndrome can be caused and influenced by many different factors, including factors related to your original condition, your surgical history, and your overall health. Other causes include:
Mistakes during surgery
Surgical complications, such as an infection or a hematoma (blood pooling) at the surgical site
Altered biomechanics, such as a changed gait pattern after spinal fusion
Denervation-related muscular atrophy near the surgical site, which can occur as a result of prolonged manipulation of the muscles near the spine during surgery
Psychological, social, or behavioral issues that interfere with the healing process, such as smoking, depression, anxiety, or lack of social support
How Is Failed Back Surgery Syndrome Diagnosed?
Dr. Melamed treats a second opinion as a fresh investigation, not a rubber stamp of the last one. He reviews the original operative notes and imaging, then re-maps your current symptoms to see whether they match what was actually treated. New MRI or CT imaging, and at times targeted diagnostic injections, help pinpoint whether the pain is coming from scar tissue, a recurrent herniation, an adjacent level, or a source that was missed the first time. The aim is a clear answer about what is generating the pain today.
At The Spine Pro, Dr. Melamed and his colleagues will use a thorough and holistic approach to identify the cause of your pain. Dr. Melamed will begin by taking a careful history of your back pain. He will ask about the type, location, and severity of your pain and how it affects your life. He may also perform a physical exam to evaluate your posture, gait, and physical function, and may recommend imaging, such as X-rays, CT scans, or MRI imaging, to identify the source of your pain.
Failed Back Surgery Syndrome Treatment Options in Beverly Hills
Not every case of failed back surgery needs another operation, and Dr. Melamed says so plainly when that's true. Once the real source is identified, many patients improve with a focused non-surgical plan — targeted therapy, image-guided injections, or radiofrequency treatment aimed at the specific structure now confirmed to be at fault. The priority is to avoid piling one large surgery on top of another.
When a procedure genuinely will help, the goal is a precise, muscle-sparing revision rather than a bigger, more destabilizing operation. Where the anatomy allows, Dr. Melamed uses biportal endoscopic techniques to free a scarred or still-compressed nerve or clear a recurrent herniation through incisions under a centimeter, sparing the muscle that prior open surgery disrupted. The whole approach is to do the smallest, most targeted thing that resolves the pain you have now.
The symptoms of failed back surgery syndrome can be extremely frustrating, and the path to successful treatment is not always straightforward. At the Spine Pro in Beverly Hills, you’ll find comprehensive, compassionate, and holistic care for your back pain. Dr. Melamed is an expert at navigating the complexities of failed back surgery syndrome and will use a combination of treatment options to address your symptoms. Dr. Melamed specializes in holistic and noninvasive treatments for back pain. Depending on your symptoms, needs, and the cause of your failed back surgery syndrome, he may recommend strategies like physical therapy and nonopioid pain medications, alternative healing methods like yoga and acupuncture, and lifestyle or diet modifications.
Dr. Melamed prioritizes noninvasive and minimally invasive treatments. If your failed back surgery syndrome does not respond to conservative treatments, he will carefully evaluate and discuss your surgical options. He is an expert in minimally invasive back surgery techniques and will work with you and your treatment team to find the best option for you.
Recovery from failed back surgery syndrome is possible. Recent studies recommend multidisciplinary strategies, incorporating psychological support, pain management, and noninvasive treatment strategies that avoid repeated surgeries. Careful and individualized management can reduce the pain and symptoms of failed back surgery syndrome and restore your function and quality of life.
Dr. Melamed and his colleagues at The Spine Pro have the expertise to support your recovery here in Beverly Hills and will work closely with you throughout your recovery process to ensure the best possible outcome.
Watch Dr. Melamed explain
Fixing Failed Back Surgery · Dr. Hooman Melamed on YouTube
Questions About Pain That Persists After Spine Surgery
Does failed back surgery syndrome mean my surgeon made a mistake?
Not necessarily. More often it means the original operation didn't fully address what was driving the pain, treated the wrong level, or that a new issue developed nearby such as scar tissue or breakdown at the next segment. Dr. Melamed's job is to find what's causing your pain now, not to assign blame for the past.
Will I need another surgery to fix it?
Often not. Once the true pain source is identified, many patients improve with focused therapy, targeted injections, or radiofrequency treatment. Dr. Melamed only recommends a further procedure when it clearly will help, and when he does, he favors a small, muscle-sparing revision over another large operation.
Why get a second opinion from Dr. Melamed specifically?
Revision and post-surgical cases are a core part of his practice, and his approach is to treat a second opinion as a genuine fresh investigation — reviewing the prior imaging and operative notes, re-mapping your symptoms, and being honest about whether another surgery is even the answer. Many patients come to him for exactly this reason.
