Pain Management for Post-Laminectomy Syndrome

When a surgeon performs surgery, he or she aims to reduce or eliminate pain. That pain might be in the back or leg due to a spinal nerve compression. However, there are times when surgery for pain management is not successful. When the surgical intervention does not achieve what it was intended to do, it is known as Post-Laminectomy Syndrome.

Sadly, about 20% of Americans who undergo surgery on their spines will still have some degree of persistent pain in their back or legs. Fortunately, despite the failure of the surgery, a trained doctor can diagnose and develop a plan for pain management for post-laminectomy syndrome.

However, there are a variety of factors that cause Post-Laminectomy Syndrome. In some cases, the spinal nerve root, which the surgery intended to decompress, did not recover from its initial trauma. Despite the surgery, the effects of the initial injury may continue to cause pain. Another source of chronic post-operative pain is the scar formation, which surround the nerve roots. Another common cause is the presence of changes in the spine that have developed above or below the site of spinal fusion. Other causes of chronic pain post-surgery include recurrent herniation, post-operative spinal or pelvic ligament instability, and myofascial pain.

Of course, the symptoms of Post-Laminectomy Syndrome depend on the cause. Whether it is from scar formation or from nerve roots, symptoms of this physical illness can vary. Symptoms include a dull and achy pain or feeling a sharp, stabbing pain that radiates from the back down to the legs, or a similar pain to that which you experienced prior to your surgery.

There is a kind of pain that is strongly related to Post-Laminectomy Syndrome, which is neuropathic pain. It is caused by injury to the nervous system, likely precisely where the damaged nerve root which led you to have surgery in the first place. Neuropathic pain is related to central sensitization, which is the reorganization of the pathways in which pain is communicated to the brain. There are many reasons for this reorganization; however the experience of central sensitization can lead to chronic pain.

Whether it is a physical or psychological disorder, an accurate diagnosis is always incredibly important. With the right diagnosis, the most appropriate treatment can follow. Various forms of intervention can be used to treat and to facilitate pain management for Post-Laminectomy Syndrome in a way that eventually leads to living pain-free.

By Dr. James  Lin
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