Patients with postlaminectomy syndrome who develop recurrent lumbar disc herniation following prior spinal surgery present a distinct clinical challenge. Persistent or returning pain after an initial operation requires careful assessment to determine whether a surgically correctable cause is present.
This protocol addresses postlaminectomy syndrome arising in the context of recurrent lumbar disc herniation after spinal surgery. Surgical management is reserved for patients with a documented anatomic or pathologic cause for their pain and/or with failed medical treatment — and only when a lesion amenable to surgical intervention is identified.
For the first recurrence of lumbar disc herniation in this setting, the evidence-based approach centres on a specific surgical intervention. The complete decision algorithm — including patient selection criteria, sequencing, and considerations for subsequent recurrences — is set out in the full protocol.