Post-Laminectomy Syndrome
Advanced management for persistent post-surgical pain
Understanding Post-Laminectomy Syndrome
Post-laminectomy syndrome, also known as failed back surgery syndrome, refers to chronic pain that persists or develops after spinal surgery. Despite the name, it can occur after any type of spine surgery and doesn't necessarily indicate surgical failure. The condition affects 10-40% of patients undergoing lumbar spine surgery.
The pathophysiology is multifactorial and may include epidural fibrosis, recurrent disc herniation, spinal instability, or nerve damage. The condition is particularly frustrating for patients who underwent surgery expecting pain relief. Treatment is complex and typically requires a multidisciplinary approach.
Common Causes
Epidural Fibrosis
Excessive scar tissue formation around nerve roots causing compression
Recurrent Disc Herniation
New herniation at the same level or retained disc fragments
Spinal Instability
Inadequate fusion or hardware failure causing abnormal motion
Adjacent Segment Disease
Degeneration of levels above or below surgical site
Arachnoiditis
Inflammation of the arachnoid membrane surrounding spinal nerves
Nerve Damage
Surgical injury to nerve roots during the procedure
Symptoms
Persistent or recurrent low back pain
Radicular pain (sciatica) into legs
Numbness, tingling, or weakness in legs
Pain worse than before surgery
Difficulty walking, standing, or sitting
Muscle spasms in back or legs
Functional limitations affecting daily activities
Associated depression, anxiety, and sleep disturbance
Advanced Treatment Options
Epidural Steroid Injections
Fluoroscopy-guided injections to reduce nerve root inflammation
Epidural Adhesiolysis
Percutaneous procedure to break down scar tissue and deliver medications
Radiofrequency Ablation
Targeting facet joints or other pain generators identified through blocks
Spinal Cord Stimulation
Highly effective with superior outcomes compared to repeat surgery in many cases
Intrathecal Drug Delivery
Implanted pump delivering pain medications directly to spinal fluid
Revision Surgery
Carefully selected cases with clear structural pathology may benefit
Multidisciplinary Rehabilitation
Comprehensive programs combining therapy, counseling, and medication
Get Expert Treatment for Post-Laminectomy Syndrome
Schedule a consultation with our pain management specialists to discuss personalized treatment options.