Post-Laminectomy Syndrome (PLS)
Post-Laminectomy Syndrome (PLS) is a condition characterized by chronic pain following back or neck surgery. Spine surgery is always performed to help relieve pain and symptoms, but sometimes it can provide no benefit or make symptoms worse. Many factors can contribute to the onset or development of PLS, including residual or recurrence of disc herniation, persistent post-operative pressure on a spinal nerve, scar tissue in the healing or healed surgical site (fibrosis), depression, anxiety, or muscular weakness and deconditioning. A patient may also be predisposed to the development of PLS due to presence of diabetes, autoimmune disease, tobacco use, or peripheral vascular disease.
Typically, symptoms develop over time after surgery, but can be present in the immediate post-operative period. Symptoms include dull or aching pain in the neck or back, tingling or burning in associated limbs, and progressive weakness or disability with activity.
Management includes therapies directed at decreasing pain intensity and improving functionality through:
- Physical Therapy and TENS
- Medication Management
- Epidural Steroid Injections
- Facet or Median Branch Nerve Blockade and Ablation
- Spinal Cord Stimulation with Implanted Devices
- Dorsal Root Ganglion Stimulation
- Sacroiliac Joint Injection or Fusion