Post-Laminectomy syndrome
If you have had prior surgery to decompress the nerves, usually a laminectomy or diskectomy, there is residual scar around the nerves. Post-laminectomy syndrome describes either nerve or back pain around the area of surgery. Scar tissue is usually blamed, but if there is residual stenosis around the nerves, instability of the spine or disk inflammation, there can be correctable problems. If you are still experiencing problems after surgery, see a spine specialist for a full evaluation.
A complete work-up includes a complete history and a neurologic assessment. X-rays of the spine with flexion and extension views can find instability. If a fusion was done, a CT scan can find a fracture or failure of fusion. MRI scans are most helpful to check the nerves for inflamation, scar tissue or residual stenosis.
Often pain management is done to help allieviate symptoms. Medications to calm the nerves and pain medications can provide some relief. Epidural steroid injections can be tried, but often do not penetrate the scar tissue. The failure of surgery to relieve the symptoms leads to a very difficult problem to help.
Surgery to decompress the area is complicated by scar tissue. Likely, the wider decompression will remove more bone and create less mechanical stability. Often times a revision surgery will require a fusion to stabilize the spine and protect the nerves. Any revision surgery carries with it higher complications, greater technical difficulty and longer recovery from surgery.
A complete work-up includes a complete history and a neurologic assessment. X-rays of the spine with flexion and extension views can find instability. If a fusion was done, a CT scan can find a fracture or failure of fusion. MRI scans are most helpful to check the nerves for inflamation, scar tissue or residual stenosis.
Often pain management is done to help allieviate symptoms. Medications to calm the nerves and pain medications can provide some relief. Epidural steroid injections can be tried, but often do not penetrate the scar tissue. The failure of surgery to relieve the symptoms leads to a very difficult problem to help.
Surgery to decompress the area is complicated by scar tissue. Likely, the wider decompression will remove more bone and create less mechanical stability. Often times a revision surgery will require a fusion to stabilize the spine and protect the nerves. Any revision surgery carries with it higher complications, greater technical difficulty and longer recovery from surgery.
