Understanding Post Laminectomy Syndrome: Causes, Symptoms, and Treatment

What is Post Laminectomy Syndrome?

The failed back surgery syndrome, called post laminectomy syndrome, is a condition that affects individuals who have undergone spinal surgery. Despite surgical intervention, some patients continue to experience persistent pain, leading to chronic pain syndromes and decreased quality of life.

Post laminectomy syndrome refers to the development of chronic spinal pain following spinal surgery, particularly lumbar laminectomy. The initial surgical procedure relieves pressure on the spinal cord or nerve roots.


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Causes of PLS Chronic Pain Syndromes

Post laminectomy syndrome happens when people still have pain after spine surgery. Common causes include:

  • Neck pain

  • Chronic back pain

  • Nerve injury

  • Spinal cord problems

  • Recurrent disc herniation

  • Scar tissue buildup (epidural fibrosis)

  • Spinal stenosis

  • Autoimmune disorders

  • Spinal surgery or herniated disc can cause nerve compression, leading to radicular pain.

Doctors may try treatments like epidural steroid injections or spinal cord stimulation to help with pain relief. Managing pain after back surgery is essential, and doctors work on ways to relieve pressure and improve function. Finding the proper treatment to help resolve chronic low back pain and enhance quality of life is critical.

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Symptoms of Post Laminectomy Syndrome

Symptoms of post laminectomy syndrome can include:

  • Ongoing pain in the back or neck, even after spinal surgery.

  • Persistent discomfort, especially in the area where they had the operation.

  • Radicular pain that travels down the arms or legs.

  • Scar tissue buildup and spinal instability.

Doctors need to do a physical examination and ask about symptoms to diagnose this condition accurately.

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Diagnosis of Failed Back Surgery Syndrome

Diagnosing post laminectomy syndrome involves a careful examination by a pain physician or specialist. Doctors will ask about symptoms like chronic back pain or persistent discomfort in the neck or spine.

They may also conduct a physical examination to check for signs of nerve root compression or increased scar tissue buildup.

Accurate diagnosis is crucial to determine the best treatment options. This may include further imaging studies, such as MRI or CT scans, to assess the spinal column and identify any underlying issues.

Once diagnosed, post laminectomy syndrome can be effectively treated with various approaches, including spinal cord stimulation, pain medications, or physical therapy.

Pain specialists work closely with patients to manage symptoms and improve quality of life.

Treatment Options

Post Laminectomy Syndrome Treatment Options

Usually post laminectomy syndrome is treated to relieve pain, improve function, and enhance quality of life. Depending on the underlying cause and severity of symptoms, treatment options may include:

1. Nonsteroidal anti-inflammatory drugs (NSAIDs) or anti-inflammatory medication to reduce inflammation and alleviate pain.

2. Epidural steroid injections to target inflammation and provide pain relief.

3. Spinal cord stimulation is a minimally invasive procedure that delivers electrical pulses to the spinal cord to interrupt pain signals.

5. Facet joint injections or nerve blocks to alleviate pain by targeting specific nerves or joints in the spine.

6. Neuropathic pain medications to manage nerve-related pain.

7. Repeat surgery or spinal fusion in cases of persistent or severe symptoms.

Post laminectomy syndrome is treated with a combination of medication, physical treatment, and other conservative measures.

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Understanding Spinal Surgery in PLS

Failed back surgery syndrome is a condition where people continue to have pain after spine surgery. This can cause ongoing discomfort, such as persistent back pain or neck pain.

Failed back syndrome can occur after different types of spinal surgeries, including those done on the lumbar spine or cervical spine. One common cause is nerve root compression, which can happen due to issues like herniated discs or inflammatory spinal pain.

Treatment aims to manage symptoms and improve quality of life. This may involve physical treatment to strengthen muscles and improve mobility. Pain management strategies, such as opioid medications or nerve blocks, may also be used to help control post laminectomy pain. Additionally, nicotine replacement therapies may be recommended for those with peripheral vascular disease to improve blood flow and support healing. 

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Prevention of PLS

Patients who undergo spinal surgery should be aware of the potential to develop post laminectomy syndrome and discuss preventive measures with their healthcare provider.

Prevention of post laminectomy syndrome involves minimizing risk factors and optimizing surgical outcomes. Patients should adhere to post-operative rehabilitation programs, avoid smoking to reduce the risk of complications such as epidural fibrosis, and maintain a healthy lifestyle to support spinal health.

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In Conclusion

Post laminectomy syndrome is a challenging condition characterized by persistent spinal ache following spinal surgery. With accurate diagnosis and comprehensive treatment approaches involving pain management, physical treatment, and surgical intervention when necessary, individuals with post laminectomy syndrome can find relief and improve their quality of life. Collaborative care involving pain physicians, surgeons, and rehabilitation specialists is essential for effectively managing this complex condition.

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