Name of the Condition

• Postlaminectomy syndrome, not elsewhere classified
• Also known as: Failed back syndrome, Failed back surgery syndrome (FBSS)

Summary

• Postlaminectomy syndrome refers to persistent or recurring back pain and/or leg pain following a laminectomy, a surgical procedure intended to alleviate back pain by removing part of the vertebra called the lamina. Despite surgery, some patients continue to experience pain due to various underlying reasons.

Causes

• Possible causes include nerve damage during surgery, inadequate spinal fusion, scar tissue formation, or disease progression that was not addressed by the initial surgery.

Risk Factors

• Risk factors include smoking, obesity, advanced age, extensive prior spine surgeries, and underlying conditions such as diabetes that affect healing processes.

Symptoms

• Chronic pain in the back or legs, limited mobility, and sometimes increased pain in other regions as the body compensates for the original source of discomfort.

Diagnosis

• Diagnosis typically involves patient history evaluation, physical examinations, and imaging studies such as MRI or CT scans to assess structural changes post-surgery.

Treatment Options

• Treatments may include pain management with medications like NSAIDs or opioids, physical therapy to improve mobility, nerve blocks, or surgical revision in severe cases. Radiofrequency ablation and spinal cord stimulation may help manage chronic pain.

Prognosis and Follow-Up

• Prognosis varies: some individuals find symptomatic relief, while others may continue to experience persistent pain. Regular follow-ups are crucial to monitor pain levels and adjust treatments as necessary.

Complications

• Potential complications if untreated include chronic pain leading to reduced quality of life, psychological impacts such as depression, and further physical deterioration.

Lifestyle & Prevention

• Maintaining a healthy weight, quitting smoking, and engaging in regular, appropriate exercise can improve outcomes. Prevention focuses on careful surgical planning and realistic expectations regarding surgery outcomes.

When to Seek Professional Help

• Seek professional help if experiencing severe pain, loss of sensation or strength, or bowel and bladder dysfunction. These may indicate serious complications requiring urgent care.

Additional Resources

• The American Academy of Orthopaedic Surgeons (AAOS)
• National Institute of Neurological Disorders and Stroke (NINDS)

Tips for Medical Coders

• Ensure coding specificity by noting the type of post-surgical syndrome accurately.
• Avoid common errors like miscoding fibromyalgia or other similar syndromes instead of postlaminectomy syndrome. Always cross-reference with surgical history for confirmation.