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Definition

Post-Laminectomy Syndrome is also referred to as failed back syndrome and is characterized by residual and persistent back and/or leg pain following spine surgery.

Causes

There are many possible factors that could be the cause of pain in those diagnosed with Post-Laminectomy Syndrome. The decompression of the spinal nerve root during surgery may not fully recover, continuing to be the source of chronic nerve pain in the back and/or the legs (sciatica). Other times, scar tissue formed during the healing process may surround the nerves and cause pain. In some instances, the vertebrae adjacent to the surgical site may change structurally. Other causes include recurrent or new disc herniation, post-operative spinal or pelvic ligament instability (such as SI joint dysfunction), altered joint mobility, and spinal muscular deconditioning.

Symptoms

With Post-Laminectomy Syndrome, the desired outcomes of pain reduction or elimination are not fulfilled. The symptoms may be similar to the pain experienced before surgery. You may feel a dull and achy pain primarily located in the spinal column or a sharp and stabbing pain radiating down the legs, similar to sciatica. Abnormal sensitivity (hyperalgesia) to heat and pressure may also occur. The pain may range from mild to severe.

Diagnosis

As with all health conditions, the best treatment plan requires an accurate diagnosis. With Post-Laminectomy Syndrome, the cause of the residual pain must be found. Imaging tests such as x-rays, MRIs, EMGs, and x-ray guided diagnostic spinal injections will help diagnose the source of pain.

Treatment

A comprehensive treatment plan will be tailored to address the individual and specific diagnosis. Non-surgical treatment may be appropriate and can include physical therapy, spinal manipulation, anti-inflammatory medications (NSAIDS), spinal cord stimulation, and spinal injections. In some cases, revision surgery may be required to eliminate the pain.