Post laminectomy syndrome, also known as failed back syndrome, occurs when laminectomy back surgery has failed to relieve a patient’s back pain or the associated disability. Its most prominent symptom is continuing post-surgery pain in the back and legs. Post laminectomy syndrome can be caused by surgery-induced nerve root damage, spinal fusion or physical traits or conditions that disqualified the patient for the procedure, but were not recognized by doctors before surgery. In some cases, the condition is the result of poorly-performed surgery.
The goal of the laminectomy surgical procedure is to relieve pain caused by nerve root injury or nerve compression, also known as radiculopathy, in the spine. These conditions are usually caused by the narrowing of the spinal canal, also known as spinal stenosis and disc herniation. The procedure involves taking away a portion of the bony arch that forms the back portion of the spinal canal. If performed correctly, this helps to relieve pressure on the back.
Common symptoms of post laminectomy syndrome include dull, aching pain in the legs and back. There may also be a pricking or stabbing pain that affects the extremities. In all affected areas, the pain will typically persist without subsiding.
A doctor will usually perform several tests in order to be sure of a post laminectomy syndrome diagnosis. These can include an magnetic resonance imaging (MRI), x-ray or electromyogram (EMG). Some doctors may also use diagnostic spinal injections guided by x-ray to reach a diagnosis.
If the condition is diagnosed, several non-surgical measures can be taken to manage pain from post laminectomy syndrome. Treatment can include drugs, exercises to stabilize the spine, injections and physical therapy. Other methods include spinal cord stimulation, radio frequency denervation or minor nerve blocks. Often, these measures are combined to meet the needs of a particular patient.
Most back surgery patients do not suffer from post laminectomy syndrome. Those who do can be physically or mentally predisposed to the condition. The syndrome is also more common among patients who have had one or more other failed surgeries.
Patients who have suffered a psychiatric illness such as depression are at a higher risk of post laminectomy syndrome. There is also a higher rate of risk among individuals who have vascular disease, diabetes or autoimmune disease. The condition tends to occur in patients who regularly smoke cigarettes as well, as nicotine is believed to interfere with the metabolism of bone.
