Why Does Scar Tissue Form Following Back Fusion Surgery?

The body naturally produces scar tissue to help with the healing process, as is the case following spinal fusion surgery. Though it’s rare to have pain specifically linked to scar tissue, it can happen. Today, we’re going to focus on what causes scar tissue after spinal fusion surgery and what you can do about it.

What Exactly Is Scar Tissue?

Scar tissue is thick fibrous tissue created by the body when the healing process is triggered. This is a largely beneficial process, but it can sometimes contribute to unexpected pain. However, it’s sometimes confused with normal post-surgery discomfort. If scar tissue is affecting the area around your fusion, you may notice:

• Pain and stiffness around the surgical site
• Limited range of motion
• Pain triggered by certain movements that normally don’t cause any discomfort

Why Might Scar Tissue Cause Pain?

Scar tissue itself contains no nerve endings. It’s believed internal scar tissue contributes to pain when too much scar tissue is produced and binds to a nerve root in the part of the spine where the fusion procedure was performed. This excessive scar tissue production near a nerve root is referred to as epidural fibrosis.

Could You Have a Secondary Source of Pain?

It’s common for scar tissue to be considered a likely cause of continued pain after spinal fusion surgery such as transforaminal interbody fusion. Santa Monica patients should be aware, however, that there could be a secondary source of postoperative pain. For instance, there may be something else going on with your spine in another area, or the true source of your pain may have been overlooked.

What Is the Exception to Scar Tissue Pain?

It’s not unusual to have a spinal disc in the lower back removed (lumbar discectomy) before fusion surgery takes place. In this case, it’s possible for excess scar tissue to cause a gradual increase in pain about 6–12 weeks after surgery. This is also roughly the same amount of time it takes scar tissue to form. However, scar tissue probably isn’t the cause of your discomfort if you notice:

• Pain that’s pretty much continuous after surgery
• Discomfort in another area of your spine where you didn’t have surgery
• Pain that develops several years after your procedure

What Can You Do to Prevent It?

You can’t prevent scar tissue entirely after you have spinal fusion surgery. However, what you can do is take steps to keep things moving around the nerve roots near your surgical site as you heal and recover. Your physical therapist will probably encourage you to do regular stretching exercises to achieve this goal. You may also benefit from:

• Range-of-motion exercises
• Massage therapy
• Low-impact forms of exercise that gently target soft tissues around your spine
• A special technique (Graston technique) that breaks up excess scar tissue

Scar tissue is just one of several possible reasons you might have lingering or worsening discomfort after spinal fusion surgery. Similar issues could result if the fusion itself doesn’t form correctly or hardware slips out of place. For this reason, it’s important to contact your Santa Monica spine surgeon to discuss anything that seems out of the ordinary as you recover. 

Get in touch with The Spine Institute if you think you’re having pain because of post-surgery scar tissue or you have any kind of lingering or severe back or neck pain. Dr. Hyun Bae and his team of expert surgeons help patients find effective relief for their chronic back and neck pain. Call 310-828-7757 to schedule an appointment.


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