Our Summary

Approximately 20% of adults in the US suffer from chronic pain. In the past half-century, a minor surgical procedure called spinal cord stimulation has gained recognition as an effective treatment for chronic pain. This research paper discusses a case study of a 46-year-old woman who had chronic pain due to two conditions: post-laminectomy syndrome (a condition that can occur after back surgery) and chronic pancreatitis (long-term inflammation of the pancreas). This is the first documented case of using spinal cord stimulation to treat two types of pain simultaneously: neuropathic (nerve-related) and visceral (related to internal organs). The treatment significantly relieved the patient’s pain in her lower back, legs, and upper abdomen. This suggests that spinal cord stimulation could be a useful treatment option for patients who have both visceral and somatic (body-related) pain symptoms.

FAQs

  1. What is spinal cord stimulation and how can it help manage chronic pain?
  2. Can spinal cord stimulation be used to treat both neuropathic and visceral pain simultaneously?
  3. What is post-laminectomy syndrome and how can spinal cord stimulation alleviate its symptoms?

Doctor’s Tip

A helpful tip a doctor might tell a patient about spinal laminectomy is to make sure to follow post-operative care instructions carefully, including proper wound care, physical therapy exercises, and pain management techniques. It is important to listen to the body and not push too hard during the recovery process to avoid complications. Additionally, maintaining a healthy lifestyle with regular exercise and proper nutrition can help support healing and prevent future spine problems. Regular check-ups with the doctor are also important to monitor progress and address any concerns.

Suitable For

Patients who are typically recommended for spinal laminectomy are those who are experiencing symptoms of spinal stenosis, herniated discs, or other conditions that are causing compression of the spinal cord or nerves. These patients may have symptoms such as chronic back or leg pain, numbness or weakness in the extremities, difficulty walking or standing for long periods of time, or loss of bladder or bowel control.

In some cases, patients may also have undergone a previous spinal surgery, such as a laminectomy, and are experiencing persistent or worsening symptoms despite conservative treatments. These patients may be recommended for a revision surgery to address the underlying cause of their symptoms.

Overall, patients who are recommended for spinal laminectomy are those who have not found relief from conservative treatments and are experiencing significant pain or disability as a result of their spinal condition.

Timeline

Before spinal laminectomy:

  1. Patient experiences chronic back pain, leg pain, and other symptoms related to spinal stenosis or other spinal conditions.
  2. Patient undergoes diagnostic tests such as MRI or CT scans to determine the cause of their symptoms.
  3. Patient may undergo conservative treatments such as physical therapy, medications, or injections to manage their pain.
  4. If conservative treatments are ineffective, patient may be recommended for spinal laminectomy surgery.

After spinal laminectomy:

  1. Patient undergoes spinal laminectomy surgery to remove part of the lamina to relieve pressure on the spinal cord or nerves.
  2. Patient may experience pain and discomfort in the immediate post-operative period.
  3. Patient undergoes rehabilitation and physical therapy to regain strength and mobility.
  4. Patient may experience improvement in their symptoms over time as the surgical site heals and the pressure on the spinal cord or nerves is relieved.
  5. Patient may require ongoing pain management and follow-up care to monitor their progress and address any complications or ongoing symptoms.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal laminectomy include:

  1. What is a spinal laminectomy and how does it help with my condition?
  2. What are the potential risks and complications associated with a spinal laminectomy procedure?
  3. What is the recovery process like after a spinal laminectomy?
  4. Are there any alternative treatments or therapies that I should consider before proceeding with a spinal laminectomy?
  5. How long will it take for me to experience relief from my symptoms after the procedure?
  6. Will I need physical therapy or rehabilitation after a spinal laminectomy?
  7. What is the long-term outlook for my condition after a spinal laminectomy?
  8. Are there any lifestyle changes or precautions I should take after the procedure to prevent further complications?
  9. Are there any restrictions on activities or movements that I should be aware of after a spinal laminectomy?
  10. How often will I need follow-up appointments to monitor my progress after a spinal laminectomy?

Reference

Authors: Cox CJ, Wilkinson MM, Erdek MA. Journal: Pain Manag. 2022 Mar;12(2):123-129. doi: 10.2217/pmt-2021-0065. Epub 2021 Aug 12. PMID: 34380321