Every cut in the body results in subsequent healing, which involves the repair of the tissue that was cut with fibrous tissue. Post-surgical fibrosis, strictly speaking, corresponds to scarring secondary to any surgical procedure. The term scar tissue is usually used to refer to those cases in which the scarring is excessive, so that more fibrous tissue is formed than is necessary. If after a spinal operation that scar tissue compresses a nerve, it causes great pain.
Risk factors
The main risk factors for developing post-surgical fibrosis depend on:
– The scar tissue: The more blood the surgical wound and the larger, the greater the risk of fibrosis.
– Individual propensity: Some people have a spontaneous tendency to heal more than necessary and even small cuts in the skin give rise to large scars (“keloids”).
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Prevention
Preventing the risk of post-surgical fibrosis is very important, since it is a painful situation where treatment is complex and not always possible. The best way to prevent the risk of post-surgical fibrosis is:
– Be operated only when all other options have been tried.
– The use of less aggressive surgical techniques whenever possible, such as microsurgery, which generate less bleeding and smaller scars.
Symptoms
The pain that typically causes post-surgical fibrosis depends on the type of surgery.
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The pain can radiate to the leg (in case of surgery of the lumbar spine). Or to the arm (in case of cervical surgery). This is more intense than the pain located in the back. The pain, although it may get worse in some postures, can be almost constant.
Not all pain that appears after a spine surgery is due to post-surgical fibrosis. For example, in a herniated disc surgery, although perfectly performed, does not prevent pain from facet joints or muscular spasms.
Risks
Sometimes post-surgical fibrosis can compress a motor nerve fiber, causing numbness, pins and needles or loss of strength.
Diagnosis
Magnetic resonance imaging can detect post-surgical fibrosis. The medical history and physical examination are essential to determine if the fibrosis detected in the MRI is the cause of the pain.
Neurophysiological tests allow the detection of nerve fiber compression.
Treatment
In the past, when it was diagnosed that the cause of pain was nerve compression due to post-surgical fibrosis, the patient was reopened to “release” the compressed nerve. But after a few months the scar from the second surgery used to produce an even greater compression. Also, the more times the patient was operated, the worse the problem.
Nowadays, with exceptions, specialists prefer to treat post-surgical fibrosis with other treatments or with methods of pain surgery, such as implantation of stimulation electrodes or morphine pumps.
What is a Nerve Root Injection?
At the London Spine Unit, we have some of the best specialists to treat the aforementioned condition. Book an appointment to get a checkup.
What are the symptoms of post-surgical fibrosis?
The pain that typically causes post-surgical fibrosis depends on the type of surgery. The pain can radiate to the leg (in case of surgery of the lumbar spine). Or to the arm (in case of cervical surgery). This is more intense than the pain located in the back. The pain, although it may get worse in some postures, can be almost constant.
How to diagnose post-surgical fibrosis?
Magnetic resonance imaging can detect post-surgical fibrosis. The medical history and physical examination are essential to determine if the fibrosis detected in the MRI is the cause of the pain. Neurophysiological tests allow the detection of nerve fiber compression.