This protocol addresses postlaminectomy syndrome arising in the context of recurrent lumbar disc herniation following prior spinal surgery. Patients in this situation present with persistent or returning pain after an initial operative intervention, with further anatomical or pathological changes driving ongoing symptoms.
Management differs depending on the recurrence number. Surgical management of postlaminectomy syndrome should be reserved for patients with a documented anatomic or pathological cause for their pain and those who have not responded to medical treatment. The approach to a second recurrence of lumbar disc herniation is distinct from earlier recurrences and requires a specific surgical strategy.
For a second recurrence of lumbar disc herniation, the evidence points toward a surgical fusion strategy combining both posterior and anterior components — the complete sequence, criteria, and procedural details are in the full protocol.
They suggested that in recurrent disc herniation, with the first recurrence best was microdiscectomy and the second recurrence, posterior fusion with anterior grafting.
Surgical management of FBSS should be reserved for patients with a documented anatomic or pathologic cause for their pain and/or with failed medical treatment.
View source ↗