Patients typically undergo spine surgery to correct abnormal anatomical problems that are causing neck/arm or back/leg symptoms, depending on the level of the spine that is suspected to be problematic. Many of these patients do well with these surgeries, but some continue to have persistent pain despite adequate healing of the surgical site. This condition is referred to as post-laminectomy syndrome or failed back surgery syndrome.
With cervical post-laminectomy syndrome, symptoms typically involve neck or neck and arm pain that persists despite surgical intervention and adequate healing of the surgical site. These symptoms do not only occur after laminectomy, and can also occur after cervical fusion or discectomy.
With lumbar post-laminectomy syndrome, symptoms typically involve persistent low-back or low-back and leg pain despite surgical intervention and adequate healing of the surgical site. These symptoms can occur after lumbar laminectomy, discectomy, and fusions.
The term “post-laminectomy syndrome” is a catchall phrase implying pain after spine surgery. Discussion of causes is far more complex. Different clinical scenarios may have different causes.
You may have had spinal surgery, recovered well, and now have developed a new and separate problem at an adjacent level. Or you may have had spinal surgery, and despite the procedure being successful, you ae experiencing unchanged or worsened pain. Finally, a you may have had spinal surgery and developed some type of post-procedure complication such as nerve damage, infection or a failure for the surgery to achieve the intended anatomical goal.
At the JLR Center for Pain Medicine, we believe the most important initial treatment is a proper evaluation with a qualified specialist who understands how to diagnose and treat complex chronic pain issues. This evaluation includes a detailed history, a thorough physical examination, and acquisition and review of appropriate imaging.
A crucial component in creating the proper long-term treatment plan is to establish an accurate diagnosis. Treatment may focus on utilization of medication to temporarily alleviate some of the pain signals as a diagnosis is established.
Minimally invasive injections such as epidural steroid injection or a selective nerve root block may be utilized to confirm the source of your pain and provide some therapeutic relief. Physical therapy may be utilized as part of a multi-pronged plan to restore function and mobility. Pain psychologists may be consulted to address the inevitable impact chronic pain has on mood. Finally, cases of post-laminectomy syndrome that are resistant to other treatments may be treated with spinal cord stimulation.