These conditions can occur in patients that have had either a laminectomy or a multi level fusion. Normally our spinal nerves slide through a structure called the neural foramen as we move our limbs, a phenomenon known as “neural flossing”. When a patient needs an operation to take pressure off the nerves or stabilize the spine, scar tissue forms in the area that has been operated on. This can cause the nerves to be tethered in a bed of scar, such that moving the limb causes repeated tugging of the nerve. The nerve reacts by become more and more sensitive over time, potentially getting to the point where patients experience continual and intractable back and leg pain.
Early in the process patients can perform aggressive neural flossing exercises and try a series of medications. Other patients need a more definitive solution, which can be achieved with a spinal cord stimulator. Please see our treatment section on neuromodulation and spinal cord stimulation for more details.