Failed Back Surgery Syndrome
Failed back surgery syndrome (FBSS) is a condition where patients who have undergone one or more spinal surgeries do not achieve the expected improvement or develop new pain after surgery. Although the term contains the word "failed," it does not always mean surgical error; it also includes cases where the patient's symptoms persist despite technically successful surgery.
What is Failed Back Surgery Syndrome (FBSS)?
FBSS is a serious clinical condition that can occur in approximately 10-40% of patients who undergo spinal surgery. These patients typically struggle with chronic pain, functional limitations, and reduced quality of life.
Causes of FBSS
- Incorrect diagnosis: Failure to correctly identify the true source of pain before surgery.
- Inadequate decompression: Incomplete relief of nerve compression.
- Recurrent herniation: New disc herniation at the same or different levels.
- Epidural fibrosis: Excessive scar tissue formation at the surgical site.
- Spinal instability: Movement disorder developing after surgery.
- Facet joint syndrome: Degeneration in small joints.
- Sacroiliac joint dysfunction: Pain originating from pelvic joints.
- Arachnoiditis: Inflammation of spinal cord membranes.
- Psychological factors: Chronic pain syndrome, depression.
Symptoms and Signs
- Persistent back pain: Continuation of pre-operative pain.
- New type of pain: Different character pain after surgery.
- Leg pain: Sciatica-like symptoms.
- Numbness and tingling: Signs of nerve damage.
- Limited mobility: Difficulty with daily activities.
- Sleep disturbances: Inability to sleep due to pain.
- Psychological symptoms: Depression, anxiety, hopelessness.
Diagnostic Process
- Detailed history: Previous surgeries, pain character, treatment responses.
- Physical examination: Neurological evaluation, movement tests.
- Imaging: MRI, CT, dynamic X-ray.
- Diagnostic blocks: Injections to identify pain source.
- Electrophysiological tests: EMG, nerve conduction studies.
- Psychological evaluation: To understand the effects of chronic pain.
Treatment Options
Conservative Treatment
- Physical therapy: Customized rehabilitation program.
- Medication: Various drug combinations for pain management.
- Epidural injections: Steroid and anesthetic injections.
- Facet blocks: For joint-related pain.
- Radiofrequency ablation: Deactivation of nerve endings.
Surgical Treatment
- Revision surgery: Correction of previous surgery.
- Endoscopic epiduroscopy: Cleaning of scar tissue.
- Spinal cord stimulation: For chronic pain control.
- Intrathecal drug pump: For resistant pain.
- Fusion surgery: In case of instability.
Prof. Dr. Salim Şentürk's Approach
Prof. Dr. Salim Şentürk pays special attention to FBSS patients. He meticulously evaluates each patient's history, reviews previous surgical records, and tries to determine the true source of pain.
Thanks to his expertise in endoscopic techniques, he applies minimally invasive approaches in scar tissue cleaning and revision surgeries. Advanced neuromodulation techniques such as spinal cord stimulation are also among the treatment options.
Other Treatments
Spine Surgery
Surgical treatment of spine and spinal cord diseases
Deformity Surgery
Deformity surgery is the surgical correction of scoliosis, kyphosis, and spinal imbalance. Effective treatment is achieved with modern techniques and implants. Prof. Dr. Salim Şentürk's expertise in complex deformity surgery.
Endoscopic Spine Surgery
Endoscopic spine surgery is a minimally invasive technique performed through an 8 mm incision. Same-day discharge and rapid recovery are possible for lumbar and cervical disc herniations. Prof. Dr. Salim Şentürk's endoscopic surgery expertise.
Peripheral Nerve Surgery
Peripheral nerve surgery treats nerve compressions, injuries, and tumors. Carpal tunnel, cubital tunnel, and nerve tumors are treated surgically. Prof. Dr. Salim Şentürk's nerve surgery expertise.
Reviewed by: Prof. Dr. Salim Şentürk, Neurosurgeon
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