Why Open Spine Surgery Fails?

Failed Back Surgery Syndrome (FBSS) also known as Post Laminectomy Syndrome (PLS) is not a diagnosis, but rather a general term to describe a variety of chronic pain syndromes experienced by patients after open spine surgery (1). The exact cause of Post-Laminectomy Syndrome is unknown, however one prominent theory points to:

• Removal of lamina (spine bone) causing muscles to proliferate & formation of adhesions with unprotected dural membrane since many important structures like ligamentum flavum is removed in open spine surgery (Laminectomy). These adhesion may also involve nerve roots & give rise to severe pain(3).
• Arachnoiditis or inflammation within the protective layers of the spinal cord.
• Surgical intervention at the wrong spinal level (the operated level may not be source of pain)