Are you wondering what Post-laminectomy Syndrome is? Why does it occur and what are its signs? Read on this article and you will find the answers to these questions.
Fixing deformed structures, decompressing pinched nerves, and bracing the spine for safe motion are all standard spinal surgery approaches for treating anatomical problems that cause pain.
Patients with failed back surgery symptoms may have the same pain as before the surgery, as well as new symptoms such as numbness, weakness, stiffness, worse pain, or more diffuse pain, or discomfort in a different part of the body.
This article will discuss what happens when a laminectomy procedure isn’t as successful as the doctor and patient had hoped, as well as Post-laminectomy Syndrome and the treatments available.
Post-Laminectomy Syndrome
A laminectomy is a procedure used to treat “pinched nerves.” Because the nerve is “compressed,” the surgical procedure is also referred to as “Decompression Surgery.” To relieve pressure on the damaged nerves, bone is removed from the Lamina of the spinal vertebrae.
A vast number of people have had successful laminectomy surgeries. These aren’t the kinds of people we regularly encounter at work. Post-laminectomy Syndrome (PLS) or Failed Back Surgery Syndrome (FBS) patients come to us looking for non-surgical solutions to their back pain.
It’s possible that the surgery failed to decompress the nerve, that the root cause of the back pain was not addressed, that there was previously unanticipated nerve damage, that the patient has a recurring disc herniation, that the spinal fusion failed, or that the procedure failed for another reason.
Before prescribing a medication, doctors will recommend a set of tests to discover the cause of the persistent discomfort (and potentially another back surgery). Depending on the diagnosis, a doctor may prescribe a combination of anti-inflammatory medicines, opioids, neuromodulatory pharmaceuticals, nerve block injections, spinal cord electrical stimulation, and/or additional surgery.
Because it puts a lot of strain on the spine, back surgery is only considered a last resort treatment for back pain. While it has been shown to be useful for many people, there are some occasions where patients continue to have back pain after the operation. Post-laminectomy syndrome is a condition that arises after a back surgery that does not provide appropriate pain relief, also known as failed back surgery.
Signs & Symptoms of Post-Laminectomy Syndrome
Post-laminectomy syndrome manifests itself in a variety of ways, but it always includes low back or neck pain, as well as limb pain.
Post-laminectomy syndrome is characterized by axis spinal discomfort, also known as low back or neck pain. This pain is typically caused by a problem with one of the structures in or surrounding the spinal column, and a variety of factors can cause it, including:
• Muscle spasm caused by a traumatic incident or a lack of muscle conditioning
• Arthritis of the spine’s facet joints
• A disc herniation
• Difficult instrumentation (for example, when the metal has been used to secure a spinal fusion)
• Complications from surgery, such as infection or bleeding
Neurologic symptoms that radiate from the spine to other body regions, most commonly the arms or legs, are common in patients with post-laminectomy syndrome. Neurologic pain can resemble any natural sensation such as heat, cold, or electricity, but it is produced by injured nerves rather than an issue with the extremity.
Neurologic symptoms include feelings of heaviness, genuine lack of strength, and, less commonly, bladder or bowel problems. These symptoms can come from a known problem with a specific nerve or group of nerves, such as a recurring disc herniation or arachnoiditis, a painful inflammation of the nerve’s lining cells. Still, they can also occur for no obvious reason, making neurologic discomfort difficult to identify and treat.
Why Does Back Surgery Fail?
There could be several reasons why your back surgery did not produce the desired results. One of the most prevalent causes is damage to the spinal nerve root. Although the operation did not cause harm, it did not help it recover from the trauma it had previously experienced.
Another possible cause is the creation of scar tissue when the body strives to heal itself after surgery. It’s also possible that your body reacts unfavorably to the structural changes made to your spine, which is a typical complication of failed spinal fusion treatments.
Causes of Post-Laminectomy Syndrome
This is a difficult topic to answer since, while post-laminectomy syndrome is referred to as a single entity, it is a complex disorder. A person who has had previous spinal surgery and is in pain is said to have post-laminectomy syndrome (not necessarily even a laminectomy). As a result, this condition could be present in a number of different ways. Here are some versions that could be used:
• The patient has developed a new, unrelated spinal disease after recuperating from spine surgery.
• Despite the fact that the procedure occurred without a hitch, the patient’s initial agony persisted.
• The patient had spinal surgery and had difficulty thereafter, such as an infection, nerve injury, or incapacity to recuperate.
The situation becomes even more complicated when you consider the role that human behavior plays in the expression of pain. People grieve in a number of ways and for a variety of reasons on various occasions.
Long-term narcotic pain medication use in people with persistent pain, particularly post-laminectomy syndrome, should be evaluated. Narcotic medicines, including opioids, such as oxycodone or morphine, work by binding to the body’s natural endorphin system, which controls whether a sensation is pleasant or unpleasant.
In fact, most opioids bind so strongly to the endorphin pathway that they drown out our bodies’ natural endorphins, preventing the brain from producing these pain-relieving chemicals.
In the long run, this may lead to an increase in total pain perception as well as the development of opioid drug tolerance. This unusual condition is known as opioid-induced hyperalgesia.
Patients and clinicians should use pain drugs with prudence wherever possible, due to the increased risk of long-term pain; and be aware of the substantial short-term hazards that these medications represent, such as addiction, respiratory suppression, constipation, nausea, itching, and other adverse effects.
How to Deal with Post-Laminectomy Syndrome?
The most important thing you can do is get a thorough evaluation. This means talking with a physician who is experienced in analyzing this sickness to reevaluate your current status, even if you have done so previously.
A comprehensive physical examination and high-quality radiologic imaging are essential to establish no ongoing mechanical or neurological problems that could cause discomfort.
Non-Surgical Approaches to Deal Post-Laminectomy Syndrome
Physical activity and rehabilitation, particularly core stabilizing exercises, joint mobility stretching, and weight-bearing strength training for the limbs, are important parts of a multi-modal treatment plan for chronic spinal pain.
When pain becomes too severe or does not respond to nonsteroidal anti-inflammatory medication, a more thorough evaluation is required, like incorporating interventional procedures.
Inflammation within the spinal column is a common cause of back pain, which can be diagnosed and treated with fluoroscopically guided injections. Examples include common techniques like epidural steroid injection and more complicated methods like radiofrequency facet ablation.
By removing a compressing item or lowering inflammation in the surrounding area, neurological discomfort, or pain produced by injured nerves, can be alleviated.
Local injection of anti-inflammatory medication around the affected nerve may assist in certain cases. For more severe nerve damage issues, anti-convulsant or anti-depressant medicine may be required.
In circumstances where a patient with neurologic pain does not respond to or tolerates these medicines, treatment with an implanted spinal cord stimulator may be successful in lowering symptoms.
Noninvasive treatments such as nerve blocks, spinal cord stimulation, and facet joint injections can usually cure post-laminectomy syndrome satisfactorily. Radiofrequency neurotomy is another treatment option.
An expert in spinal pain can examine your situation and help you decide on treatment alternatives. Even if this situation is difficult, there is a way to move forward and find the comfort you require.