SPECTRUM OF POST LAMINECTOMY SYNDROME AND ITS MANAGEMENT

Abstract

Introduction: Post laminectomy syndrome is becoming an increasingly common challenge for clinicians who deal with spinal disorders owing to the expanding indications for spinal surgery and the aging world population. A multidisciplinary approach is most appropriate for patients who are unlikely to benet from further formal surgical intervention. Surgical intervention is the last resort for post laminectomy syndrome. However patients with visible cause for low back pain can benet from surgery. Material And Method: It is a prospective study that was conducted in our institute for 2 years. Patients coming to our institute with lowback pain (LBP) or LBP along with radiculopathy who underwent lumbar spine surgery for the same cause were included. All patients were evaluated with Gadolinium enhanced MRI to look for epidural brosis, brosis around nerve roots, extruded disc, infections. Results: Total of 48 patients were included in the study. 29 patients were managed conservatively and 19 patients were operated. 89.5% of the operated patients had a favourable outcome post operatively and 82% had a favourable outcome in the conservative group. 5 patients had postoperative complication in the form CSF leak and infection. Conclusion: Post laminectomy syndrome management has been always a multimodality treatment. Patients with epidural and nerve root brosis are always poor candidates and surgery should be avoided in such cases. Psychiatric counselling and physiotherapy are also invaluable in conservatively managed groups