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Failed Spinal Pain Management

Introduction

Failed Spinal Pain Management often occurs when surgical solutions do not restore the patient’s quality of life. In many cases, these patients are referred to Chronic Pain Management due to the inability of surgeons to pinpoint the pain’s origin or the risks associated with conventional surgery.

Causes:

  • Incorrect identification of the pain source.
  • Inadequate or insufficient treatment.
  • Chronic Pain Management centres rely heavily on MRI/CAT scans which might not always accurately represent the pain’s origin.

Symptoms:

  • Severe back or neck pain.
  • Numbness, weakness, spasm.
  • Pain sensations akin to boiling or iced water running down the limbs.

Pain Origin: Only 11% of patients experience pain directly from the disc. Most pain is caused by irritation or pressure on the nerves around the spinal area. Degeneration or damage to the disc can lead to nerve sensitization, causing pain.

Conventional Diagnosis:

  • Relies on MRI & CAT scans.
  • Clinical examinations often do not correlate with the patient’s actual pain.
  • Loss of disc height and dehydration, often evident in MRI scans, can lead to nerves getting pinched, causing irritation and pain.

Conventional Treatments:

  • Physiotherapy, osteopathy, chiropractic techniques.
  • Use of pain medications.
  • Steroid injections.
  • Nerve ablations or irritant injections for scarring.
  • Dorsal Column Stimulator for blocking pain signals to the brain.

Why is Aware State Diagnosis Superior?

It provides accurate identification of the pain source through patient feedback during surgery. This real-time feedback helps surgeons pinpoint and address the exact cause of the pain.

Diagnostic Confirmation

Hydraulic discography and spinal probing can accurately identify the segment causing the pain. These techniques offer more precise insights into the pain’s origin, especially in cases where conventional methods fall short.

Alternative Treatments

Transforaminal Endoscopic Lumbar Decompression & Foraminoplasty (ELDF) offers targeted treatment with minimal tissue damage and better long-term outcomes. Post-surgery, high-energy sources like lasers are used to remove scarring and ensure faster recovery.

Success Rates: Aware State Diagnosis and ELDF Surgery have a success rate of over 80% when reviewed 2-4 years post-surgery and 70% after 10 years.

Thank you - From the Spinal Foundation