Post laminectomy syndrome/Failed back syndrome

What it is:

What Is Post-Laminectomy Syndrome?

Post-Laminectomy Syndrome (PLS) refers to persistent or recurrent pain following spinal surgery, especially after a laminectomy—a procedure to relieve pressure on spinal nerves. It’s also known as Failed Back Surgery Syndrome (FBSS), though this term is being replaced by more neutral terms like Chronic Pain After Spinal Surgery (CPSS) or Persistent Spinal Pain Syndrome (PSPS).

Causes of Post-Laminectomy Syndrome

PLS can result from a variety of factors:

Scar tissue formation compressing nerve roots (epidural fibrosis)
Incomplete decompression of spinal nerves
Recurrent disc herniation
Surgical intervention at the wrong spinal level
Spinal instability or degeneration
Infection or inflammation (e.g., arachnoiditis)
Psychological factors like depression or anxiety
Opioid-induced hyperalgesia from long-term pain medication use

Symptoms of Post-Laminectomy Syndrome

Symptoms vary but commonly include:

Persistent back or neck pain
Radiating pain in arms or legs
Numbness, tingling, or weakness
Stiffness or limited mobility
Sharp, stabbing, or burning pain
Pain similar to or worse than before surgery
Sleep disturbances, anxiety, or depression

Diagnosis

Diagnosis involves:

MRI or CT scans to assess structural changes
Electromyography (EMG) for nerve function
Pain mapping and physical exams
Review of surgical history and symptoms timeline

Treatment Options

1. Non-Surgical Management

Physical therapy and rehabilitation
Pain medications (NSAIDs, antidepressants, anticonvulsants)
Epidural steroid injections
Nerve blocks
Cognitive behavioral therapy (CBT)

2. Advanced Interventions

Spinal cord stimulation (SCS)
Intrathecal pain pumps
Radiofrequency ablation
Minimally invasive procedures for nerve decompression

3. Revision Surgery

Considered only when imaging shows a correctable issue
Success rates decline with each additional surgery

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Call us at (561) 433-4444 to schedule a consultation or make an appointment.
Let our experienced doctors help you manage post-laminectomy syndrome and improve your quality of life.