Post Laminectomy Syndrome, sometimes known as ‘failed back syndrome’, is a term used to refer to persistent and chronic back pain after laminectomy spinal surgery. A laminectomy is a kind of spinal surgery which is designed to bring an end to chronic back and leg pain by decompressing the spinal nerve root or roots being compressed due to a disc herniation or spinal stenosis.
A laminectomy basically focuses on relieving pain felt in the legs and arms. However, when a laminectomy doesn’t bring the desired results and the chronic pain sustains or is increased after the surgery, the condition is referred as ‘post laminectomy syndrome’ or ‘failed back syndrome’.
What may actually happen is the pain may get better after the surgery, and then eventually get worse. This is an exceptional disappointment as the patient is initially ecstatic over the decreased pain, then dismayed when it comes back months later.
Causes of Post Laminectomy Syndrome
Spinal surgeries are extremely complicated and even with everything going according to plan during the surgery; sometimes the results don’t show any improvement. There are many reasons as to why a laminectomy may fail or as to why a particular patient who has gone through a spinal surgery may not feel any pain relief after the surgery.
One of the primary reasons why patients regress into post laminectomy syndrome is the reaction of the spinal nerve root to the surgery. During radiculopathy, surgeons decompress the spinal nerve root so as to alleviate pain. However, sometimes, the nerve root has been compressed for so long it does not have the capacity to recover. As a result the decompression brings no result and the pain sustains even after the surgery has been performed.
Another cause of failed back syndrome is related to the human body’s healing process. Scars are formed during any healing process and once the body starts to heal after a laminectomy, the body naturally resorts to scar formation here as well. In some cases, these scars end up gathering around the nerve root as a result of which the chronic pain comes back.
Symptoms of Post Laminectomy Syndrome
Many people don’t really give much importance to back pain or sharp pain in their limbs after a laminectomy, as they feel that the pain won’t last long as the root cause of their chronic pain has been solved through the surgery. However, usually, when chronic pain returns after the procedure, it ends up being post laminectomy syndrome.
Another potential reason for pain starting again may be breakdown of adjacent levels. It may be that the initial pain stays away, but new pain is due to a new problem. When this is the case, an additional surgery may be indicated.
Treatment Options for Post Laminectomy Syndrome
Patients who experience pain after an initially successful laminectomy due to scar tissue around the nerve root(s) that were decompressed will not benefit from a repeat surgery. The best option is nonoperative management that may consist of the following:
- NSAIDS and Tylenol
- Prescription Medications – May include opiates, Neurontin, Lyrica, etc.
- Epidural Injections – This may help if there is inflammation around the scarred nerve(s)
- Spinal Cord Stimulator Implant – this may be the best option for an individual with severe pain due to post-laminectomy syndrome. The implant may mask pain, which is great considering it cannot be surgically solved. The spinal cord stimulator implant is placed as an outpatient by the best Las Vegas Pain Management Doctors.
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