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Post-Laminectomy Syndrome

A laminectomy is a surgical option when disc material in the spine bulges out of its normal space, causing pain in the back and down the lower leg, called sciatica. This surgery removes all or part of a lamina, a piece of bone that helps support the vertebrae. Removing the lamina takes pressure off the nerve root. Post-laminectomy syndrome is diagnosed when the patient has persistent or reoccurring pain following neck or back surgery.

  1. Laminectomy Success Rates

    • According to Capitol Spine and Pain Centers, about 500,000 spinal surgeries are performed in the United States each year, and up to 20 percent of these surgeries result in some degree of continuing back or leg pain. SpineHealth.com notes that after laminectomy, 70 to 80 percent of patients show significant improvement in their ability to perform normal daily activities, as well as significantly decreased levels of pain. The surgery is particularly effective for sciatica, pain in the nerve that runs down each leg from the spine.

    Symptoms

    • Specific symptoms of post-laminectomy syndrome include neck or arm pain after neck surgery, or back or leg pain after lower back surgery. The patient may describe the pain as dull or aching and not confined to a specific area. In contrast, there might be sharp stabbing pains. He may also experience numbness, tingling and muscle weakness. Some patients develop abnormal sensitivity, such as pain when touched by a non-painful stimulus, such as a cotton swab. They also may experience heightened pain when touched by a painful stimulus, such as a pinprick.

    Causes

    • Many possible reasons exist for post-laminectomy syndrome. Although surgery may have decompressed the spinal nerve root, the nerve may not fully recover from the compression. Additionally, scar formation can occur and cause chronic pain. The patient may experience a repeated episode of disc herniation, structural changes in the spine or progression of a degenerative condition.

    Risk Factors

    • Certain risk factors make it less likely for a laminectomy to be successful. People with diabetes, autoimmune disorders or vascular disease are more prone to post-laminectomy syndrome. According to the American Academy of Spine Physicians, even depression, anxiety, insomnia and smoking are risk factors for post-laminectomy syndrome.

    Treatment

    • Repeat surgery is usually not recommended for post-laminectomy syndrome because of a higher risk of complications and longer recovery time. Pain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), can relieve symptoms. Physical therapy and lumbar stabilization exercises also can help, along with spinal cord stimulation that uses electric current to relieve pain. Physicians may recommend radio-frequency denervation or epidural nerve blocks.

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