**Failed back surgery syndrome** is a term used for pain after back or spine surgery. Pain may start immediately after surgery, weeks or months after surgery. In such conditions, daily activities or going to work become very difficult... Statistics show that one out of ten people experience back pain and it causes disability more than any other complication. More than 40% of people experience persistent back pain after spine surgery, known as failed back surgery syndrome. Predictability of failed back surgery syndrome According to the research conducted in this field, the more complicated the surgery in the spine area, the risk of developing this syndrome or FBSS also increases. For example, in a complex surgery such as spinal fusion, compared to a simpler operation such as a microdiscectomy, the risk of developing this complication is much higher. Related content: How to sleep after lumbar disc surgery It should be noted that the more the number of surgeries in the back area, the less likely the success of the surgery will be, the success rate of each operation is as follows: - up to 50% for the first time - for the second time up to 30% - for the third time up to 15% - for the fourth time up to 5% Therefore, repeating the operation to fix failed back surgery syndrome is not always the best treatment method, our recommendation is to visit a pain specialist for a specialized examination and consider the appropriate treatment solution. What are the symptoms?.. The symptoms of this syndrome may appear immediately after surgery or after a few weeks to a few years after the operation... Its symptoms include: - Some patients do not have any problems after surgery and the pain gradually appears after a few weeks. - Pain is felt in some people in the lower back or leg, and some people report both at the same time.. The pain may be similar to the pain before surgery or in a different way. - Being pressed on a part of the lumbar nerve root (L5) which leads to leg drop and is very common in this syndrome. Some patients may feel worse than the conditions we explained to you. Other sensory and motor symptoms such as weakness and numbness may recur in the patient or appear as new symptoms. familiarity with the cause and risk factors To answer this question, three categories should be considered: risks before surgery, during surgery and after surgery: ### risk factors associated with pre-surgery If these things are present before surgery, there will be a possibility of developing this syndrome: - Incorrect lifestyle that delays the healing process, such as smoking - Psychological issues such as depression and anxiety - History of several back surgeries - Obesity - the presence of problems that are likely to occur or recur, such as lumbar disc herniation and spinal canal stenosis Research results show that patients who suffer from psychological problems such as depression are more at risk of developing failed back surgery syndrome. ### Risk factors during surgery Choosing an inappropriate method during surgery for the created problem causes pain to continue after surgery... Also, when the pain originates from several different parts, treating the spine can lead to failed back surgery syndrome. ### risk factors after surgery Several reasons can be mentioned after surgery: Your symptoms may be exacerbated by surgery, or you may experience instability in the treated area or adjacent areas due to changes in the spinal tissues. Bone failure or implant failure can lead to persistent pain, dysfunction, or symptoms. Not following the restrictions after surgery is another thing that affects the healing process and causes back pain after surgery. How can this complication be avoided? The risk of failed back surgery syndrome (FBSS) may be minimized by following these tips: - Diagnosis of the cause of back pain before any treatment - Adaptation of patient symptoms and disease diagnosis - Identifying patients with high risk of failure syndrome after back surgery and preventing risk factors as much as possible - Considering the best treatment method according to the cause of pain - Informing the patient about the limitations after surgery and also the importance of physical therapy and exercise during recovery What is the treatment? Failed spine surgery syndrome can be managed with non-surgical as well as surgical treatments.. Possible treatment solutions include: ### Pharmaceutical treatment Oral medications include nonsteroidal anti-inflammatory drugs, antidepressants, anticonvulsants, and opioid pain relievers. ### Physiotherapy The aim of physiotherapy is to treat this disease and it leads to increasing muscle strength and improving range of motion in the lower back area. ### Massage Manual treatments such as massage help loosen scar tissue and remove adhesions under the skin and help increase the healing process through the formation of cells such as collagen. ### Spinal cord stimulation (SCS) SCS or spinal cord stimulation device is a pain management method in which controlled, pulsed signals are sent near the spinal cord to control back pain. Electrical signals are produced through a device that is placed on the back of the patient.. To ensure the effectiveness of spinal cord stimulation, a test is first used for the patient, and if it is desirable, it is placed permanently. ### injection treatment methods Research shows that injections in the spinal area lead to pain relief from failed back surgery syndrome, which includes: #### Injection for adhesion In this treatment method, a medicinal solution such as saline, steroid or hyaluronidase is injected in the scar area to break down the tissue and scar. #### Radio Frequency In joint radio frequency, the part of the nerve that causes pain transmission is burned with this method to prevent the pain signal from being transmitted to the brain. The effects of this treatment can last from months to years... After that, the burned nerve may heal and the pain may return. #### Epidural steroids to control inflammation Steroids are injected into the epidural space in the nerve endings and other tissues, the medicine spreads in these areas and relieves the pain. Other treatment methods are surgery, if the patient is not treated with non-surgical methods, surgery is performed at the doctor's discretion.