Re: Post Laminectomy/discectomy scar tissue

Posted By mike rattie on May 27, 1998 at 20:32:11:

In Reply to: Post Laminectomy/discectomy scar tissue posted by mike rattie on May 27, 1998 at 20:21:42:






: Dear Doctor,
: I am writing as a potential Cleveland Clinic patient.  I am a recently turned 40 resident of Pittsburgh, PA.  I had a discectomy at L3-L4 in 1994.  Recovery was unremarkable.  Surgery date was 1/1/94, I returned to work on 2/14/94, and was golfing by 3/16/94.  I had no problems with normal activities; I lifted weights and jogged routinely.  All was well until February '97.  I started getting severe pain in right hip, groin, buttock and shin.  Pain for the most part settled along anterior of right shin; burning sensation.  I had xrays of Lumbar region, MRI, Myelogram and CT scan all just about a year ago.  Results indicated several problems; I've been told it looks like I have bone cancer, I broke my back, a weird form of tuberculosis, etc, all of which turned out not to be the case.  I do have osteoarthritis (more than one would expect to see in a person my age).  It seems both a neurosurgeon and a neurologist agreed my problem was stemming from scar tissue from the discectomy / laminectomy.  The neurologist referred to it as post-laminectomy syndrom (syndrome).  The surgeon wanted to wait until I couldn't walk any more, and then cut out the scar tissue.  The neurologist suggested alternate approaches, which is what I opted for.  As a result, I had two LESI's, shoe inserts, PT, and Ultram x3/day.  A later thought was a lumbar fusion.  The PT worked for a while, but the pain along the shin is back, at times severe, and radiates into big toe.  I am now reconsidering surgery.  My concern is that if I have surgery to remove the scar tissue, the tissue will grow back, and I'll be in the same boat.  A friend told me she thought Cleveland Clinic might be able to remove the old scar tissue with a lazer.  Is this true?  I have scanned the xrays, mri, myelogram and ct into WORD documents, and can forward them to an email address if you so desire.  The bottom line-is there a surgery technique to remove the tissue without a re-occurance in a few years?  Thank you.  Mike

Dear Mike:
There is no laser surgery for prevention of scar tissue formation.
Some people just have a propensity of forming more scar tissue than others.
If you have scar forming around the laminectomy you need to have the nerve roots decompressed
or this may result in permanent injury to your nerves.
The best solution is to have a thorough decompression that will ensure
(if possible) that even scar tissue forms it will not compress the nerve
roots again. If you are interested in an opinion at the Cleveland Clinic,
I would recommend that you call the offices of Dr. Kalfas or Dr. Bingaman
at [phone]. If you have any further questions please write back!
Good Luck!