Post-Laminectomy Syndrome, or failed back surgery syndrome (FBSS) is a general term used to describe a number of chronic pain syndromes that occur after back surgery. The exact cause remains not well defined, but epidural fibrosis, where the development of scar tissue during healing compresses nearby nerve roots and causes pain. Other possible causes include:
-Surgical intervention at the wrong spinal level
-Residual or recurrent disc herniation
-Persistent post-operative pressure on a spinal nerve
-Altered joint mobility or hypermobility with instability (loose joint)
-Scar tissue (fibrosis)
-Incomplete removal of the lamina (the bone process that you feel when palpating your spine &which is removed in a laminectomu surgery to relieve pressure on the nerve root)
-Arachnoiditis, or inflammation within the protective layers of the spinal cord
-Psychosocial problems such as depression
An individual may be at higher risk if she/he has systemic disorders such as diabetes, autoimmune disease and peripheral blood vessels (vascular) disease. Smoking is a risk for poor recovery.
Symptoms include: diffuse, dull and aching pain in the back and/or legs; abnormal sensibility may include sharp, pricking, and stabbing pain in the legs.
Treatment options include:
-Opioids for pain with unpredictable response. Watch out for side effects of long-term use.
-Spinal cord stimulation via placement of electrodes into the epidural space of the spinal cord that allow an electric current to interfere with pain conduction pathways. Good results but of high rate of complications associated with electrode implantation
-Adhesiolysis or the removal of fibrotic scar tissue: mechanically, or chemically via injection of saline or other solutions
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