Post Laminectomy FBSS

Post-Laminectomy | Failed Back Surgery Syndrome

Low back pain effects up to 80% of the world’s population. When low back pain persists, surgery is sometimes required. Unfortunately, not all spinal and back surgeries are successful. In fact, an estimated 20-40% of patients find they are still experiencing discomfort, which is labelled as post laminectomy syndrome, or failed back surgery syndrome (FBSS). Failed back surgery syndrome occurs when lumbar spinal surgery does not yield the results anticipated prior to surgery.

Causes of Post Laminectomy Syndrome

There are a number of reasons failed back surgery syndrome occurs, chief among them are misdiagnosis or partial diagnosis, meaning more than one condition exists, however, only one issue is addressed with surgery.

Several other factors causing failed back surgery syndrome include:

Nerve damage
Scar tissue
Technical error
Spinal implant slippage
Epidural fibrosis
Recurrent disc herniation
Spinal stenosis
Arachnoiditis
Obesity
Smoking
Depression
Infection

Symptoms

Post laminectomy syndrome results in chronic pain that can be greater or lesser than the pain experienced before surgery, or it may be a different kind of pain altogether. Other symptoms of failed back surgery syndrome may include:

Dull, aching pain in the neck, back or legs

Full pain in the neck, back, or legs

Pain above or below surgery location

Pricking or stabbing sensation in the extremities

Loss of mobility

Spasms

Anxiety

Depression

Diagnosis

While examining for failed back surgery syndrome, a pain management specialist will first review your treatment history, namely the type of surgery performed that could be leading to FBSS. Your pain management specialist will also conduct a physical examination, as well as perform tests such as CT scans, x-rays or MRIs.

Possible Treatments

Once a diagnosis has been made, there are several treatment options to discuss with your pain management specialist, such as:

Physical therapy

Chiropractic care

Medication

Epidural Steroid Injections

Spinal Cord Stimulation (CSC)

Narcotic pumps

In some cases, more intensive care is necessary in treating failed back surgery syndrome and may include:

Radiofrequency Ablation (RFA): Radio waves are applied to a nerve, causing a temporary inability to transmit pain.
Adhesiolysis: A small catheter is inserted through the tail bone and directed into the epidural space. When the catheter reaches the site of the surgery and finds any adhesions or scar tissue, it is broken apart and moved.

If any of the above treatment options fail, your pain management specialist may recommend additional surgery such as spinal or SI joint fusion, or SI joint rhizotomy.

Dr. Raju Mantena is an anesthesiologist and pain specialist based in the Houston area and has over 15 years of medical experience which he relies upon each day to successfully treat his patients’ acute and chronic pain.

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