Post-Laminectomy Syndrome

The spine is an assassinating, dynamic entity with durable and flexible working components. It allows us to move, twist, bend and support our weight. Our spine protects the spinal cord from the area in which the spinal nerves arise. The diagnosis of your spinal condition is very important. Pain generators are sometimes difficult to find when they involve the spine especially after you’ve had back surgery. The diagnosis of post-laminectomy syndrome is often made with diagnostic nerve blocks. Occasionally this may indicate that you will need additional interventional pain procedures or that you may need additional back surgery. Blocks are often diagnostic and therapeutic in that they will tell us where your pain arises from and often will relieve that pain.

Conditions that occasionally will require surgery include degenerative disc disease, disc protrusion-herniation, facet joint arthropathy, scoliosis, kyphosis, spondylolisthesis, vertebral compression Fractures, spinal stenosis, and nerve root compression. More than one of these conditions may exist in the same individual. Many patients who have been treated with spine surgery have excellent post-operative results.

MRI scans show severe degeneration at the L5-S1 level and no other levels of degeneration.

Unfortunately, a minority of patients have unrelieved or worsened pain, despite a well-performed surgery. Some patients develop additional pain conditions, such as epidural scarring, adhesions, spinal arachnoiditis, bone spurs or additional disc herniation, which may result in nerve compression or damage. In addition, many patients develop secondary mechanical back and extremity pain as a result of strain and weakness of the spinal elements.

These patients continue to have severe pain, which requires the care of a surgeon or a pain management specialist.

Your pain management physician may order additional tests. Your diagnosis is made based upon the type and location of pain, X ray and MRI studies. Additionally, your diagnosis is based on your response to diagnostic and therapeutic injections. These will be placed on the exact site of the suspected origin of the pain.

Your doctor will recommend the most practical diagnostic injections to find the source of your pain, after which a therapeutic treatment program is offered. Therapy is usually a combination of oral medication, physical therapy and appropriately spaced interventional injection therapy. In some cases, advanced pain management techniques may be indicated. Post-laminectomy syndrome of the spine can be a chronic condition, yet with the help of a pain management specialist and appropriate interventions, treatment has been successful.