Laminectomy is a procedure where a surgeon removes a part or more parts of your vertebrae or any ligaments on your spinal cord that exert pressure on the nerves. Laminectomy is said to be the most common back surgery performed for disability and pain. The following are some expectations before, during, and after surgery.
During a Laminectomy
During a laminectomy, you will be placed under general anesthesia. You will also be on a mechanical ventilation.
- A mix of oxygen gas and general anesthesia will be delivered through a mask, which is placed over your face by your anesthesiologist. A sedative will be injected into your veins for you to relax. Since you are under general anesthesia, you will be asleep after inhaling the gas.
- An anesthesiologist will then perform an intubation, which is a process where your anesthesiologist inserts a plastic tube into your trachea via your mouth.
- During the operation, a ventilator will service your lungs with sufficient oxygen. The surgeon will monitor the progress of the entire surgery.
- To access your back, you will be in a face-down position.
The surgeon will then perform the laminectomy:
- Your surgeon will cut through the skin on your back, particularly on the affected area. The surgeon will then pull the tissues and muscles covering your spine aside.
- Your surgeon will then perform a procedure known as decompression. During the process, your surgeon cuts off the ligaments that exert pressure on your nerves. Depending on the reason for surgery, a small or larger portion of the bones can be cut off.
- To stabilize the spine, some patients may require a spinal fusion laminectomy. It is a process where the disc on the rear part of your back may be removed, or an implant may be inserted on your back to make way for the nerves around the lower back.
You will be stitched back and both the anesthesia and ventilation will be discontinued. You will be rolled back at the end of the procedure.
Preparing for a Laminectomy
Preparing Your Home
There are some things you will have to do before your surgery that will help make your recovery process easier. The following are some of the things that you should do before leaving the house:
- Place a chair near your bed or somewhere convenient for you.
- You can refrigerate homemade food and buy easy to prepare foods before leaving.
- To avoid bending and straining during recovery, put utensils and kitchen pots on the shelves.
- Find someone who will assist you with house chores, shopping, and cooking during your recovery.
- Keep your clothes, shoes, and bathroom items in a place where you can access them without having to bend.
- Remove any stuff that can make you trip and secure the floor if you will have to stay on it.
You may have to wear a brace before surgery. The brace is very important, which can also help you during your recovery. Your doctor may also request your physical therapist to prescribe an aid equipment for your recovery. You should also confirm if your medical insurance will cover the equipment or if there is a need for you to add money and pay for them.
Your therapist will help verify your insurance and order for your aid equipment. You should arrange for someone to be home to help you receive the equipment. Remember, you may need them as soon as you get discharged. The following are some of the medical equipment that you may find useful:
- A walker
- A toilet seat extender
- Tub seat or chair for the bathroom
- Long-handled tools
Your doctor may also prescribe a medical bed for you. However, it entirely depends on your surgery and medical needs.
You will have to organize a means of transportation to get home after your surgery. It is not advisable that you drive after the procedure. Therefore, arrange for a driver to pick you up after your surgery before you go to the hospital.
You should not take medications that contain aspirin since they are blood thinners. Taking such medications should be stopped at least two weeks before the operation. Ask your doctor about the drugs that you can continue taking. If in case you are in pain, you can visit your doctor for a proper prescription. If you have any other conditions, you need to inform your doctor as soon as possible to help him or her in making preparations for your surgery. Carry the list of all your recent prescriptions with you on the day of your surgery.
If you are a smoker, you need to quit at least 14 days before your surgery and at least five weeks after the surgery. Smoking can negatively affect your recovery process.
Preadmission Testing and Evaluation
You will also undergo the following tests before the surgery:
- Urine and blood tests
- Anesthetic interview
- Chest and spine X-rays
The doctor will also send you for a patient education session.
There is an option for blood donation if you want to donate blood and hold it for your use after the surgery. You can donate blood at least four weeks before your surgery. You need to get your doctor’s advice for this procedure. You may need to take iron and multivitamin supplements, which will be recommended by your doctor as well.
Evening Before Your Surgery
You may be reminded of your appointment through a telephone call from the hospital. Around 9 p.m., you will be reminded not to eat anything until after your surgery. After midnight, you should take nothing. Even fluids are not recommended.
Remember to remove any accessories such as rings or bracelets since your fingers may swell the next morning.
What to Take with You to the Hospital
For comfort, pack your own low-heeled shoes. You may need cotton T-shirts in case you will wear braces. Also, remember to pack your own toiletries and a set of underwear. Do not carry any valuables to the hospital. Any aid equipment should be brought to you after surgery.
What to Expect in the Hospital
The Morning Before Surgery
- Someone should accompany you to the hospital if necessary.
- You will take off all your clothes and wear a hospital gown. You will also have to remove all jewelry, contact lenses, wigs, and hairpins. You may be required to go to the bathroom as well.
- You will be transferred on a stretcher an hour before the operation begins. In case you have someone with you, he or she will be directed to the waiting area.
- Before entering the operating room, your anesthesiologist will engage you in a short interview and then give you intravenous shots of antibiotics. The administration of antibiotics is to help cut down the risks of infection.
- Inside the operating room, you will be under general anesthesia. The surgery may last for several hours. Your doctor may need to monitor your spine using somatosensory evoked potentials (SEPs). In this case, adhesive electrodes will be placed on you.
- You will be taken to the recovery unit immediately after your surgery where you may stay for around two hours. A nurse will monitor your heart rate, blood pressure, and temperature from time to time. The nurse will also be monitoring your dressings and limb movements.