Backgraund and Aim: We aimed to compare the results of the treatment of the patients with failed back surgery syndrome (FBSS) by mechanical lysis and steroid hylase injection via epiduroscopy due to their stabilization status and to detect the effect of pathological diagnostic markers on prognosis and ongoing tretment protocol. Methods: Eighty-two patients with FBSS symtoms were included. Two groups were composed as group I (stabilized) and group II (non-stabilized). All patients were evaluated using the oswestry disability index (ODI) and visual analogue scale (VAS) scores before and after treatment at 1, 3, 6, and 12 months and using the Patient Satisfaction Scale at 12 months following treatment. Epidural scar tissue visual and mechanical signs were also recorded. Results: Mean VAS scores were as 7.8 and 3.28 points in group I (p<0.001) and as 7.51 and 2.74 points in group II (p<0.001) at the beginning and 12th months, respectively. Mean ODI scores were as 34.05 and 22.16 points in group I (p<0.001) and as 30.74 and 19.46 points in group II (p<0.001) at the beginning and 12th months. VAS and ODI scores decreased significantly in both groups, but were more significant in non-stabilized group (p<0.001). Moderate or severe fibrous tissue was observed in 86.58% and patient satisfaction scores were very good or good in 78.06%. During the procedure, a dura rupture developed in four patients in the stabilization group and in two patients in the non-stabilization group, although none of these patients developed a spinal headache, and no significant permanent complication arose. Conclusion: We suggest that epidural adhesiolysis, hyaluronidase and steroid injection in patients with FBSS chronic low back pain and/or radicular symptoms may give reliable information about the quality of life, accuracy of diagnosis and the possible course of the present findings and may be more effective in unstabilized patients. Key Words: Failed back surgery syndrome, epiduroscopic adhesiolysis, hyaluronidase.

No abstract

Aims:Although there have been many studies about lumbar and cervical ablation procedures, few studies have been performed in the thoracic region. To evaluate the clinical results of a percutaneous disc decompression device in patients with radicular symptoms and/or dorsal pain due to thoracic disc herniation.Methods:Eleven patients with thoracic disc herniation and/or degenerative discs (all in T10-T11, or T11-T12 levels) who did not respond to conservative treatments were undergoing ablation and compression procedures. Pain and radicular symptoms consistent with the thoracolumbar region were confirmed via abnormal magnetic resonance imaging findings after detailed anamnesis and physical examination. All patients were evaluated before and 1, 3, 6, and 12 months after treatment using the visual analog scale score. The patient satisfaction scale was used to evaluate the level of patient satisfaction at the end of the treatment at 12 months.Results:The median visual analog scale score was 7.00±0.45 points before treatment and 2.73±0.65 points at 12 months post-procedure and were statistically significant (p<0.001). The results of pairwise comparisons using the Bonferroni Corrected Wilcoxon Signed-Rank test showed that there were statistically significant differences. The mean visual analog scale score at the beginning (7.00±0.45) was significantly higher than the mean score of other months. Postoperative improvement was significant with a 99% confidence interval. No complications that may cause permanent damage occurred.Conclusion:Percutaneous disc decompression is an effective and safe procedure to treat pain caused by lower thoracic intervertebral disc disease, which did not respond to conservative treatments.

Aims: Although there have been many studies about lumbar and cervical ablation procedures, few studies have been performed in the thoracic region. To evaluate the clinical results of a percutaneous disc decompression device in patients with radicular symptoms and/or dorsal pain due to thoracic disc herniation. Methods: Eleven patients with thoracic disc herniation and/or degenerative discs (all in T10-T11, or T11-T12 levels) who did not respond to conservative treatments were undergoing ablation and compression procedures. Pain and radicular symptoms consistent with the thoracolumbar region were confirmed via abnormal magnetic resonance imaging findings after detailed anamnesis and physical examination. All patients were evaluated before and 1, 3, 6, and 12 months after treatment using the visual analog scale score. The patient satisfaction scale was used to evaluate the level of patient satisfaction at the end of the treatment at 12 months. Results: The median visual analog scale score was 7.00±0.45 points before treatment and 2.73±0.65 points at 12 months post-procedure and were statistically significant (p<0.001). The results of pairwise comparisons using the Bonferroni Corrected Wilcoxon Signed-Rank test showed that there were statistically significant differences. The mean visual analog scale score at the beginning (7.00±0.45) was significantly higher than the mean score of other months. Postoperative improvement was significant with a 99% confidence interval. No complications that may cause permanent damage occurred. Conclusion: Percutaneous disc decompression is an effective and safe procedure to treat pain caused by lower thoracic intervertebral disc disease, which did not respond to conservative treatments.