Still in Pain After Spine Surgery?

Failed back surgery syndrome is a general term for pain that persists or returns after spine surgery. It is not a single problem but a group of possible causes — such as a fusion that did not heal, a nerve that is still or again compressed, hardware that has loosened, wear of an adjacent level, scar tissue, or loss of spinal alignment. The key to treating it is identifying which of these is actually causing the pain.

A fusion can fail for several reasons: the bones may not fully knit together (pseudarthrosis or non-union); the hardware may loosen, shift, or break; a nerve may remain or become compressed again; the level next to the fusion may wear out (adjacent segment disease); the spine may lose its natural alignment; or scar tissue may irritate a nerve. Dr. Hobbs uses targeted imaging to determine the specific cause in each patient.

Dr. Hobbs starts by finding the true source of the pain. That means reviewing your prior surgery, examining you, and using the right imaging — a fine-cut CT to check whether the fusion healed, flexion-extension X-rays to look for instability, an MRI (sometimes with contrast) to tell scar tissue from a recurrent disc, and standing X-rays to measure alignment. Surgery is recommended only when there is a clear, correctable problem and nonsurgical care has not provided relief.

Revision surgery is generally more complex than a first operation because of scar tissue and altered anatomy, which is why experience and precision matter. Dr. Hobbs uses image-guided StealthStation navigation, AI-driven planning, and minimally invasive techniques to work safely and accurately. He discusses the specific risks and benefits with each patient before recommending surgery.

In many cases, yes. Depending on the cause, Dr. Hobbs can often address a failed fusion with minimally invasive, tissue-sparing techniques and image-guided navigation, which can mean less pain and a faster recovery than traditional open revision. Some complex revisions require a larger approach; the plan is tailored to your specific problem.

Yes. Jonathan G. Hobbs, M.D. is a board-certified neurosurgeon who specializes in revision surgery for patients with continued or returning pain after a prior spine operation. He practices at Lakeshore Bone & Joint Institute, with offices in Crown Point, Chesterton, and Portage, Indiana.