There is a common advice given by other people to patients who have been diagnosed with a herniated disc, spinal canal narrowing or nerve compression and have been recommended surgery for treatment by their doctor: "Don't have an operation, it will get worse, you will look for this day". This is actually a very good summary of a situation known in medicine: Failed back surgery syndrome or failed back syndrome as it is used in medicine. Failed back surgery syndrome occurs when patients with inappropriate or inadequate diagnosis are diagnosed correctly, but with inappropriate or inadequate treatment. Especially in the environment where health is highly commercialized recently, hospital policies or doctor's ethics do not work well, doctors' desire to fill performance or earn money, in fact, cause some patient groups that can be treated with a non-surgical method to perform surgery. The surgery creates a tissue trauma as a result. It disrupts the normal anatomy and causes normal functions not to be fulfilled as before. Another dimension is that the patient was evaluated correctly. The patient was correctly diagnosed, but the team that took care of the patient could not intervene in one way or another. Both situations gave birth to the state of "Don't have an operation, it will be worse, you look for today", which has become an urban legend among the people, if the phrase is appropriate. This is a problem that concerns physicians to a great extent and its solution is very simple. To give the right treatment to the patient.

 

Considering the medical statistics, the incidence of failed back surgery in the population is 5-15%. Spinal canal and nerve root compression overlooked during the first surgical intervention, some post-operative complications such as adhesion, poor union, cyst formation, trauma to the nerve root, psychosocial problems of the patient, recurrent hernia or failure to remove the hernia already in the first operation Unnecessary screw and plate insertion are some of the reasons for unsuccessful back surgery. In addition, problems with bone union, wrong and insufficient union can be. This is the cause of pain. In this case, stronger fixation and more effective fusion should be performed by reoperation. There may also be problems due to the fusion of bones. The most common of these (10-15%) due to union  excessive stress may occur in adjacent segments due to biomechanical reasons, which leads to degenerative changes in adjacent joints and discs. Pain in pathologies in the joints of the lumbar spine; low back pain, groin, hip and thigh pain and rarely spread to the knee. It is a blunt pain and an increase in rotational movements and back bending of the lower back is typical.

 

The infection rate after herniated disc surgery varies between 1-4%. In discitis (inflammation of the intervertebral disc), pain that occurs shortly after the operation, especially aggravated by movement, is typical. These cases are comfortable immediately after the operation, but usually, low back pain occurs within 2 weeks, but the pain is localized in the lumbar region and increases with movement, not along the course of the nerve root. Diagnosis is made by characteristic radiological images, clinical findings, elevation of CRP and sedimentation. First of all, antibiotic treatment and absolute rest should be recommended. Hyperbaric oxygen (oxygen tent) therapy can be applied.

 

Arachnoiditis can occur after a water- or fat-soluble contrast agent. It can also occur as a result of multiple surgical interventions. Meningeal cyst (pseudomeningocele) may develop at a rate of 1% due to damage to the spinal cord (dura). In the early period, neck and leg pain and signs of radiculopathy occur. The cyst is removed and the dura is repaired. While the success rate is 85% in the early period, it drops to 60% in the long term.