REASONS AND TREATMENT FOR FAILURE IN HERNIATED SURGERY
This is a condition called "failed waist syndrome" in the medical literature.
This definition includes back surgery (herniated disc surgery, spinal stenosis surgery, etc.). ) is a condition in which there is no satisfactory recovery following surgery.
The failure rate in herniated disc surgery is approximately 8-25% worldwide.
Factors that cause or contribute to failed waist syndrome are as follows. can be listed.
- Incorrect diagnosis.
- Failure to remove the disc tissue pressing on the nerve fibers during surgery,
- Nerve fiber injuries during surgery.
- Forgotten foreign body in the surgery area.
- Breakage and mobilization of surgically fragile bones and joints in the surgery area during the recovery period.
- Renewal of a herniated disc at the same level. (It usually occurs after a very successful and painless 6-8 month period.)
- Abnormal tissues and adhesions that develop in the surgery area. (Granulation tissue and epidural fibrosis.)
- Spinal membrane injuries and accumulation of Cerebrospinal Fluid in the surgical area. (This fluid usually manifests itself as a discharge from the wound after the surgery. It is called CSF fistula.
- Bleeding in the surgery area and pressure of the blood clot on the nerve roots.
- The herniated vertebrae are not connected to each other. deterioration in articulation, loosening, loosening.
- Inflammation of the operation area, discitis, arachnoiditis developing due to infection and inflammation. (pia arachnoiditis = nerve membrane inflammation.)
What you have experienced After a herniated disc or stenosis surgery, you can feel whether the procedure is "successful" or not from the first day of your surgery. The most common causes of failed waist syndrome show symptoms immediately after the surgery.
If;
On the first day of your surgery, apart from the local pain caused by the surgical wound, if you continue to have pain in your inner hip and leg as before or more severe than before surgery,
Even though there is no pain, you experience intense and constant numbness and burning in your leg. , if there is a feeling of coldness,
If you have noticed weakness in your toes, feet and leg movements, with or without pain and often with a numbness-burning sensation:
It is highly likely that you are faced with one of the early causes of failed back syndrome. These reasons are often: "insufficient cleaning of the hernia, nerve fiber damage and blood clot accumulation in the operation area." Although very rare, foreign objects forgotten in the surgery area may also cause early symptoms.”
Even if all your complaints are gone after the surgery, CSF fistula is one of the most common complications that can occur relatively early, that is, within the first week. (Fluid leakage that occurs as a result of damage to the Cerebrospinal membrane, leaking out of the skin incision and stitching area.)
Deep infections and inflammations such as Discitis-Arachnoiditis occur within 2-4 weeks following the surgery. It usually manifests itself with unbearable pain in the waist area. The pain intensifies with even the slightest movement of the patient and even breathing. At this time, the suture area is usually clean and free of discharge.
Late causes of failed waist syndrome, that is, the causes that occur after the patient has been very well and pain-free for months:
- Recurrent-recurrent herniated disc. ,
- Sliding or instability in weakened waist bones (Spinal Spondylolisthesis, Spinal Instability),
- Abnormal wound healing tissue development and adhesions. (Granulation-Epidural Fibrosis.)
In the treatment of failed waist syndrome, a new surgical intervention, that is, surgery, is required for all of the causes, except for one or two exceptions.
In general, this type of surgery Its name is “Revision Surgery.”
Spine Revision Surgery, regardless of the reason for revision, is a much more difficult, complication-prone, comprehensive and technical intervention than the patient's first surgery.
Revision surgery must be experienced. It is recommended to be done by teams.
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