What is laminectomy?
If you have back pain that is severe enough to interfere with your day-to-day activities and other medications fail to work, you might eventually need surgery to get it fixed. Laminectomy is the surgical procedure that will be performed on your back in this case. It involves the removal of a piece or all of the lamina (vertebral bone) to ease pressure on the nerve roots or the spinal cord that may be as a result of tumors, injury, spinal stenosis, or a herniated disk.
Reasons Why You Might Need a Laminectomy
It is almost normal to experience mild lower back pain that goes away on its own after a while. The pain may be due to exhaustion or may come as a symptom of another health condition. However, lower back pain can also be severe and painful enough to interfere with your movements and functionality. When you experience this kind of lower back pain and no medication seems to work, laminectomy becomes the only way out. Laminectomy can be used to reduce the compression of the spinal nerves, get rid of a tumor on the spinal cord, or fix other disk problems.
Laminectomy is always necessary in cases of a fractured disk on the spinal cord. The disk may be damaged or displaced as a result of wear and tear or injury. This disk then exerts tension on the spinal nerves causing pain that may be accompanied by weak or numb legs and arms. The weakness and numbness may be experienced in the arms or legs depending on the region of the spine that has been affected by the disk. A sharp pain known as sciatica, which moves through the sciatic nerve, is a common symptom of a fractured disk. The pain usually travels all the way down to the legs via the buttocks and the thighs.
There are a number of medical treatments that can be tried before finally settling on laminectomy. They include:
- Drugs such as anti-inflammatory medications, pain relievers, and muscle relaxants
- Activity modification
- Injections to the spine
- Physical therapy and/or rehabilitation
- Weight loss in cases where lower back pain is caused by being overweight
- Occupational therapy
- Smoking cessation
- Mechanical back supports and other assistive devices
When all of these treatments fail to work or if the pain is accompanied by severe symptoms such as weakness and numbness in the arms and legs, your doctor will suggest for a laminectomy.
How to Prepare for a Lumbar Laminectomy
- A few weeks prior to the surgery, the doctor and the orthopedic or neurosurgeon involved will examine you to confirm if your health is up to par. You will need to be in your best health before the surgery.
- You will then meet with the anesthesiologist to decide on the best anesthesia for you, which may either be general or spinal anesthesia. You will also be required to provide a list of all the over-the-counter drugs and prescriptions that you are currently using. They will then decide which medications you will have to discontinue prior to the surgery. Some of the medications that you may be advised to discontinue in most cases are anti-inflammatory medications such as ibuprofen and aspirin. You will also be advised to quit smoking if you happen to be a smoker.
- You will undergo a number of tests such as ECGs, routine blood tests, and imaging tests such as MRIs and X-rays. These tests may vary depending on a number of factors such as age and medical conditions.
- You will probably be advised not to take any food or drink through the mouth after midnight prior to your surgery. However, you will be allowed to take medicine or brush your teeth in a good number of cases.
What are the risks involved with laminectomy?
Laminectomy is no different from any other surgical procedures and complications are bound to occur. Some of them may include:
- blood clotting in the lungs or legs
- Risks that come with general anesthesia
In other rare cases, an injury may occur in the nerves or blood vessels during the operation leading to weakness or numbness after the surgery.
There are also possible risk factors as a result of other underlying medical conditions. For this reason, you should make it a priority to keep your doctor informed of such concerns prior to your surgery.
What to expect during a laminectomy?
You will be required to stay in the hospital for a while before and after the procedure. Other procedures that you will undergo will depend on your situation and your doctor. You may be given general anesthesia, which will keep you asleep during surgery, or you may be given spinal anesthesia, which will make you numb from your waist down. Better ideas are being sorted to allow local anesthesia to be used during a laminectomy as an outpatient service. You will get more information on the same from your doctor.
Laminectomy generally involves the following:
- You will be asked to replace your clothing with a hospital gown.
- An IV (intravenous) line will be connected to your arm.
- A urinary drainage catheter will be fixed after you have been put under anesthesia.
- Any excessive hair on the surgical area will be shaved or clipped off.
- You may be placed on the operating table either on your abdomen or your side.
- Your blood pressure, breathing, blood oxygen level, and heart rate will be closely monitored throughout the procedure by the anesthesiologist.
- The surgeon or nurse will clean the surgical area with an antiseptic solution.
- An incision will then be made over the selected vertebra.
- The back muscles will then be spread apart by the surgeon.
- The surgeon will then remove the lamina to ease the pressure that was being inserted on the nerves. Any other unwanted particles such as all or part of the disk and bone spurs or growths may also be removed.
- Spinal fusion may be performed in some cases, which involves connecting two or more bones to the spinal cord to enable it to gain more stability.
- The operated area will then be stitched or closed with surgical staples.
- The surgical site will then be covered with a sterile bandage or dressing.
Laminectomy has been proven to be effective in most cases. However, its success rate can sometimes be affected by age or recurrence of arthritis. Laminectomy is most effective in reducing pain that is caused by a compressed nerve and not back pain. You may likely experience the symptoms again since laminectomy cannot prevent the buildup of osteoarthritis, which is the source of the nerve compression in the first place.
Your recovery may take a bit longer if you undergo both laminectomy and spinal fusion at the same time. It might take up to 6 months for you to fully recover and get back to your daily activities. You may, however, be able to return to your work in a few weeks if you undergo laminectomy alone. That is if your work does not involve much lifting and moving. It is advisable to make sure that you feel well and back to normal prior to resuming work.