What is Post-Laminectomy Syndrome?
Post-laminectomy syndrome is a condition in which a patient suffers from persistent pain after receiving back surgery, specifically a laminectomy. A laminectomy is a spinal procedure that removes a piece of the vertebra that protects the spinal cord and forms the spinal column. The piece of vertebra removed is called the lamina, and it is the back part of the bone which covers the spinal canal.
Typically, this procedure is performed to relieve pressure on the spinal cord from a protruding disc or bony overgrowths in the spinal canal. For this reason, a laminectomy is commonly known as decompression surgery. While some patients recover without any complications, others experience continuous back and leg pain. This persistent pain after the procedure is referred to as post-laminectomy syndrome. However, it can also be classified as Failed Back Surgery Syndrome, or FBSS.
What Causes Post-Laminectomy Syndrome?
Traditional open back surgery is associated with an inherent risk of injury or even surgical failure. However, many preoperative indicators determine the likelihood of success of a laminectomy. For one, a laminectomy should only be performed once conservative treatment, such as medication or physical therapy, fails to improve symptoms. Secondly, a laminectomy should only be performed once a patient’s condition has been properly diagnosed.
The most common cause of post-laminectomy syndrome is an initial misdiagnosis. Bony overgrowths within the spinal canal can narrow the space available for your spinal cord and nerves, creating a pressure which causes pain, weakness, and numbness. However, spinal stenosis, a condition which narrows the spinal canal, can have a similar effect. Inaccurate diagnosis is a major factor leading to post-laminectomy syndrome, with as many as 58 percent of FBSS cases resulting from undiagnosed stenosis of the lumbar spine.
Other common causes of post-laminectomy syndrome include:
- The compressed spinal nerve root does not fully recover from its prior trauma and continues to be a source of chronic pain.
- A bone spur continues to grow, and is now impinging on nerves. Bone spurs are developing conditions, and surgery cannot guarantee their growth will stop entirely with surgery.
- Recurrent disc herniation. Similar to bone spurs, herniated discs are a degenerative condition which can continue to occur after surgery.
- Resulting scar tissue impinging on spinal nerves. When scar tissue binds spinal nerves, it can lead to epidural fibrosis, which eventually leads to pain and the development of post-laminectomy syndrome.
- Spinal instability due to the removal of too much of the lamina. In the case of open back surgery, removing too much of the back of the vertebra can lead to spinal instability that can result in a herniated disc or other conditions.
- Technical issues during surgery. As with any procedure, technical issues during the surgery can lead to alternate spinal conditions or the development of post-laminectomy syndrome.
- Lifestyle habits such as smoking and failing to adhere to post-operative rehabilitation can lead to an insignificant decrease in pain.
Symptoms to Recognize a Failed Laminectomy
Following a laminectomy procedure, a variety of red flags can arise that will let a patient know that the surgery was not successful. The most common symptom that patients experience is back pain at the site of surgery, along with leg pain. When a surgeon conducts a follow-up examination, patients suffering from post-laminectomy syndrome will still complain of tenderness at the site of surgery.
- Muscles spasms
- Restricted mobility
- Altered posture or gait
- Depression and anxiety
- Limited flexibility in the spine
- Difficulty performing daily activities
- Difficulty sleeping or staying asleep
- Aching pain in the neck, back, or legs
- Pain above or below the treated level of the spine
Post-Laminectomy Syndrome Treatment
When attempting to recover from a back surgery that was ineffective, one of the last things you want to do is go back under the knife. According to the National Center for Biotechnology Information (NCBI), up to two-thirds of all chronic pain patients enrolled in pain centers in the United States are believed to have experienced failed back surgery syndrome – and data suggests that chronic back pain post–spinal surgery should be treated non-operatively unless progressive neurologic deficits exist.
A first-line of treatment many doctors recommend will be medication, specifically morphine-based painkillers in high doses. As expected, this treatment option can develop a dependence on opioids and have a variety of negative side effects. As an all-natural, non-addictive treatment method, chiropractic is a highly favored therapy that can help reduce pain and improve range of motion.
The use of chiropractic to manage post-surgical pain relies on a multitude of factors, including your original diagnosis as well as the reasoning behind the failed surgery. While all post-laminectomy syndrome patients are eligible to receive chiropractic care, the therapies used may vary depending on the condition of the spine. Generally speaking, so long as there is no surgical metal left behind, chiropractic treatment begins by decreasing deep-tissue inflammation. Once inflammation has been reduced, a chiropractor performs spinal manipulation to restore mobility to the spine through light and controlled pressure.
Chiropractic treatment for post-laminectomy syndrome includes:
- Ultrasound therapy, to target deep-tissue inflammation
- Electric stimulation, to reduce inflammation and pain
- Spinal manipulation, to reduce spinal restriction and alleviate pain
- Flexion-distraction mobilization, to reduce pain and improve mobility
- Physical therapy, to improve an altered posture or gait following surgery
- Acupuncture, to promote healing and further reduce pain
- Activator Technique, a gentle approach to manipulating the spine
The combination of the above techniques used in the order of anti-inflammatory then mobilization will allow doctors to work on the affected area without having to apply anything more than a light force.
Can Chiropractic Cure Post-Laminectomy Syndrome?
Realistically, post-laminectomy syndrome has no clear-cut cure. Depending on the source of the condition, pain may be able to be managed and reduced to a minimum. However, if permanent nerve damage occurred, not even a follow-up surgery could potentially heal the damage.
Chiropractic care cannot correct the damage done by a failed surgery, however, it can relieve the pain you’re currently experiencing, as well as, help decompress nerves. Chiropractic care can non-invasively and naturally make life more comfortable, improving your range of motion and making daily activities pain-free. It is possible to enjoy life, even after a failed spinal surgery left you in immense amounts of pain.
If you’re experiencing post-laminectomy syndrome, contact ChiroCare of Florida today. Our trusted physicians will work with you to compose a personalized treatment plan that will address the pain symptoms your failed surgery left behind. With 10 offices in the South Florida area, there is always a ChiroCare of Florida office nearby.
