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Revision & Complex Spine Care

Failed Back Surgery Syndrome

If you are living with persistent or recurring pain after a previous spine surgery, you are not out of options — and it is not in your head. There is almost always a real, identifiable reason. Dr. Tyndall specializes in finding the true cause of continued pain and offering a clear, honest path forward.

What Is Failed Back Surgery Syndrome?

Failed back surgery syndrome (FBSS) — also called post-laminectomy syndrome or persistent spinal pain syndrome — is an umbrella term for back or leg pain that continues, or comes back, after spine surgery. The name sounds discouraging, but it is important to understand what it really means: it is not a single disease, and it does not mean nothing can be done.

It is simply a description of an outcome — the surgery did not relieve the pain as hoped — and that outcome can have many different underlying causes. Sometimes a disc re-herniates. Sometimes a nerve was never fully freed. Sometimes the spine has changed in the years since surgery, or the original problem was never the true source of pain in the first place.

The single most important step in treating FBSS is not the next procedure — it is correctly identifying why the first surgery did not work. Once the real pain generator is found, the path forward usually becomes much clearer. That careful, detective-style evaluation is exactly where Dr. Tyndall, with his specific expertise in complex revision spine care, focuses his attention.

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Why a Previous Surgery May Not Have Worked

Continued pain after spine surgery almost always traces back to one of a handful of specific, identifiable causes. Tap each one to see what it is in plain language.

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Signs You May Have FBSS

Check any of the following that sound like your experience since spine surgery.

This self-check is for education only and is not a diagnosis. Only a thorough evaluation with a spine specialist, including a physical exam and imaging, can determine what is actually causing your pain.

Dr. Tyndall's Approach: Find the Cause First

Too often, patients with FBSS are simply offered another operation without a clear answer to the most important question: why did the last one not work? Dr. Tyndall takes the opposite approach. He begins with a fresh, comprehensive re-evaluation — treating you as a new puzzle to be solved, not a repeat of the prior plan.

That evaluation includes a full history, a careful physical examination, a review of your prior operative records, and the advanced imaging needed to answer specific questions. The goal is to identify the actual pain generator before recommending any treatment at all.

The Right Test for Each Question

MRI (sometimes with contrast)
Examines the discs, nerves, and soft tissue — and helps tell scar tissue apart from a recurrent disc herniation.
CT scan
Shows bone detail and assesses any prior fusion — better than MRI for evaluating how bone has healed.
X-rays
Reveal overall alignment and the position and integrity of any hardware.
Flexion / extension views
Capture the spine in motion to uncover hidden instability that static images can miss.

Conservative care comes first. Once the cause is understood, Dr. Tyndall favors the least invasive path that can relieve your pain — which often means non-surgical options such as pain management, targeted injections, and physical therapy, and referral for neuromodulation (such as a spinal cord stimulator) when that is the most appropriate fit.

Revision surgery is recommended only when a clear, correctable structural cause is found and conservative measures have not provided enough relief. When surgery is the right answer, Dr. Tyndall favors minimally invasive and motion-preserving techniques to address the specific problem while protecting the rest of your spine. If surgery is not the answer, he will tell you honestly and help you find the care that is.

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What to Expect at Your Consultation

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Your Path Forward

Every patient's path is individualized. The right next step depends entirely on what the evaluation reveals about the true source of your pain.

When to Seek Care Urgently

Certain symptoms can signal a serious problem that needs immediate attention. If you experience new or progressive weakness, worsening numbness, or any loss of bladder or bowel control, do not wait — go to the nearest urgent care or emergency room, or call 911. These can be signs of a surgical emergency.

Why Choose Dr. Tyndall

When a previous surgery has not delivered relief, the surgeon you turn to next matters more than ever. Dr. Tyndall pairs deep revision expertise with the judgment to recommend surgery only when it is truly the right answer.

Complex Revision Expertise
Specific expertise in evaluating and treating patients with continued or returning pain after a prior spine operation
Board-Certified, 20+ Years
Board-certified orthopedic spine surgeon (MD, FAAOS) with more than two decades of specialized spine experience
Elite Training
NYU medical degree, Stanford residency, and a spine fellowship at the Hospital for Special Surgery (HSS)
Conservative-First Philosophy
Non-surgical options are explored first; revision surgery is recommended only when a clear, correctable cause is found
Minimally Invasive & Motion-Preserving
First in Indiana with computerized navigation for outpatient MISS; an advocate for techniques that protect your spine
Lakeshore Bone & Joint Institute
Practicing at Northwest Indiana's most preferred orthopedic and spine practice, with a 4.9/5 rating across 300+ reviews

Frequently Asked Questions About FBSS

Failed back surgery syndrome, or FBSS, is an umbrella term for pain that persists or returns after spine surgery. It is not a single disease but a description of an outcome that has a wide range of possible causes, such as a recurrent disc herniation, an incompletely relieved nerve, wear of an adjacent level, scar tissue, hardware problems, spinal instability, or an original diagnosis that did not match the true source of pain. Treating it begins with identifying which of these is actually responsible.
A spine surgery may not relieve pain for several reasons: a disc can re-herniate at the same level, a nerve may remain compressed if decompression was incomplete, the level above or below a fusion can wear out (adjacent segment disease), scar tissue can tether a nerve, hardware can loosen or irritate tissue, the spine can become unstable, or the original pain source may have been different from what was treated. Dr. Tyndall uses a comprehensive re-evaluation and advanced imaging to determine the specific cause in each patient.
In many cases, meaningful improvement is possible. The key is correctly identifying the real pain generator first. Depending on the cause, relief may come from pain management, targeted injections, physical therapy, neuromodulation such as a spinal cord stimulator, or revision surgery when a clear, correctable structural problem is found. FBSS is not the end of the road; Dr. Tyndall's goal is to find a path forward that fits your specific situation.
Not necessarily. Many patients with FBSS improve with nonsurgical care such as targeted injections, physical therapy, pain management, and neuromodulation. Dr. Tyndall recommends revision surgery only when a clear, correctable structural cause is identified and conservative options have not provided enough relief. When surgery is appropriate, he favors minimally invasive and motion-preserving techniques whenever possible.
Yes. Dr. Tyndall regularly evaluates patients whose initial spine surgery was performed by another surgeon or at another facility. Bringing your prior operative reports and imaging helps him understand what was done and identify what may have been missed or what has changed. A fresh, comprehensive second opinion is often the most valuable step for someone with continued pain after spine surgery.
Dr. Tyndall starts with a detailed history and physical examination, then uses the imaging needed to answer specific questions: an MRI to look at the discs, nerves, and soft tissue (sometimes with contrast to tell scar tissue from a recurrent disc), a CT scan to assess bone and any prior fusion, and X-rays including flexion and extension views to check alignment and look for hidden instability. The goal is to identify the actual pain generator before recommending any treatment.
Dr. Dwight S. Tyndall, MD, FAAOS, is a board-certified orthopedic spine surgeon with specific expertise in complex revision spine surgery and more than 20 years of experience. He is a pioneer in minimally invasive and motion-preserving spine surgery and practices at Lakeshore Bone & Joint Institute, with offices in Crown Point and Schererville, Indiana.

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Get a Fresh Look at Your Spine

If you are still in pain after spine surgery, a fresh, comprehensive evaluation can find what was missed. Bring your prior records and imaging — Dr. Tyndall will help you understand what is going on and what your real options are. Call today to schedule your consultation.

(219) 250-5035

Monday – Friday · 8:00 AM – 5:00 PM

Crown Point Office

500 E. 109th Avenue
Crown Point, IN 46307

Schererville Office

833 W. Lincoln Highway, Suite 110
Schererville, IN 46375