Post Laminectomy Pain Syndrome


 

Post-laminectomy pain syndrome refers to pain that occurs after undergoing spinal surgery to correct problems that are causing neck and arm or back and leg symptoms. Back surgery is risky, as the operations take place close to important sensory nerves. Although surgery is performed to relieve pain, it may not be successful or even lead to pain exacerbation. Following surgery, some patients continue to have persistent, residual pain despite healing of the surgical site. The preceding surgery may also have led a post-procedure complication, and many factors can contribute to the onset or development this syndrome, including spinal disc herniation, persistent postoperative pressure on a spinal nerve, altered joint hypermobility, joint hypermobility with instability, nerve damage or nerve root compression, facet joint problems, fibrosis, depression, anxiety, sleep problems, spinal muscular deconditioning, and infections. Pain can also arise from diabetes, autoimmune disorders, peripheral vascular disease, smoking, and inflammation.

Cervical post-laminectomy syndrome involves neck and/or arm pain, and these symptoms can occur after laminectomy, cervical fusion, or discectomy. Lumbar post-laminectomy syndrome involves persistent low back and/or leg pain, and these symptoms can occur after lumbar laminectomy, discectomy, and fusions.

Diagnosis can include imaging tests like X-rays, magnetic resonance imaging (MRI), computed tomography (CT) scans, and electromyography.

Treatment options include physical therapy and anti-inflammatory medications. Epidural steroid injection or a selective nerve root block (another injectable) may be recommended to confirm the source of pain and provide relief. Spinal cord stimulation and transcutaneous electrical nerve stimulation may also be used. Both of these use electrical currents that send signals to and stimulate the affected nerve areas to provide pain relief.

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