Considering Spine Surgery called Laminectomy?

Laminectomy is a type of spine surgery used to relieve compression on the spinal cord and its emerging nerve roots. During the surgery, your surgeon will remove the lamina (segment of the vertebrae). The lamina is part of the bone that forms the vertebral arch in the back bone (spine). Your surgeon will also remove bone spurs (increased growth of the bone). These structures can put pressure on the spinal cord or nerve roots. It leads to:

The lamina is part of the bone that forms the vertebral arch in the back bone (spine). Your surgeon will also remove bone spurs (increased growth of the bone). These structures can put pressure on the spinal cord or nerve roots. It leads to:

The lamina is part of the bone that forms the vertebral arch in the back bone (spine). Your surgeon will also remove bone spurs (increased growth of the bone). These structures can put pressure on the spinal cord or nerve roots. It leads to:

  • Mild to severe low back pain
  • Numbness or weakness in the legs
  • Difficulty controlling bladder or bowel movements
  • Difficulty walking

Indication for laminectomy

A laminectomy is often done to relieve serious complications of spinal stenosis. In this condition, your spine narrows and puts pressure on the spinal cord or nerve roots. Spinal stenosis may be due to:

Spinal stenosis may be due to:

  • Conditions such as herniated disk or slipped disk both compresses any of your spinal cord or spinal nerves. Both occur with aging.
  • Spinal arthritis, which is more common in above 50 years age groups
  • A congenital or birth defect, such as abnormal growth of the spinal column
  • Conditions in which bones grow improperly such as Paget’s disease of the bones
  • Achondroplasia, which is a type of dwarfism
  • A traumatic injury
  • Tumor in the spine
  • herniated or slipped disc
  • Spinal stenosis

You may need to undergo surgery when all other options such as physical therapy, medication or other non-operative therapies fail to address your condition. So, that is when the possibility of surgery can come in handy as the last best resort.

Your doctor may suggest laminectomy in case of:

  • If non-surgical treatments such as medication or physiotherapy fails
  • Have experienced loss of bowl and bladder control
  • Have numbness or weakness that has made it difficult to stand or walk

Types of Laminectomy

According to the area of surgery it’s divided into 2 types

  • Cervical Laminectomy
  • Lumbar Laminectomy

 Image showing lumbar laminectomy

Laminectomy Procedure

A laminectomy is usually performed under spinal or general anesthetic. It can take anywhere between one to three hours depending on the complexity of the procedure and the surgery technique.

Before surgery, your surgeon explains the nature of your surgery, the reasons for it, the outcome and the possible complications involved. They should be able to tell you the exact length of stay in hospital that will be required and the number of weeks you will need to recover before returning to work.

You may initially require inpatient rehabilitation (physiotherapy) for a short period of time. Your anesthetist will visit you to see how suitable you are for operation. Diagnostic tests, including blood and urine samples, are taken before the operation.

You will have a ‘nil by mouth’ (nothing to eat) for a number of hours prior to operation. A pre-medication injection is usually given to make you drowsy and dry up some internal secretions.

The position you are placed in on the operating table depends on the position of your herniated disc or narrowing.

Your skin is marked for incision. The surgeon makes an incision through the skin. The muscle is then cut, peeled back from the vertebrae (spine bone) and held in place with special instruments called retractors. The lamina, which is between the bony projections of the vertebrae (the ‘points’ you can feel with your fingers) and the transverse process is either removed or drilled with small holes.

What happens next depends on the problem. For ex; the surgeon may then trim the protruding bits of a degenerated disc. Once the surgery is completed, the surgeon confirms the spinal cord or nerves are not compressed anymore, and the muscle and skin are sutured and closed.

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Complications of Laminectomy

All surgeries have risks. Complications occur rarely, but include the following:

  • Blood clots (DVT)
  • Nerve damage
  • Spinal fluid leak
  • Infection
  • Bleeding
  • Chronic pain
  • Risks associated with anesthesia

Recovery from Spinal Stenosis Surgery

After your surgery, you are not going to be instantly better. You will most likely be out of bed within 24 hours, and you will be on pain medications for 2 to 4 weeks. After the surgery, you will receive instructions on how to carefully sit, rise, and stand. It is important to give your body time to heal, so your doctor will probably recommend that you restrict or minimize your activities such as:

  • Don’t do any activities that move your spine too much
  • Avoid heavy lifting, contact sports while you recovering stage
  • After surgery, Report any problems—such as fever, infection, or increased pain to your doctor immediately

Follow these activities to early recovery:

  • Follow your doctor’s treatment plan
  • Sit and stand correctly
  • Learn to lift properly
  • Do regular exercises (low-impact aerobic exercise is especially good, but consult your physiotherapist first)
  • Use proper sports equipment
  • Maintain a healthy body weight
  • Stop smoking
  • Avoid excessive use of alcohol

The results with laminectomy to correct spinal deformities are usually good. 80% to 90% of patients have relief from their pain after surgery.

Physiotherapy after laminectomy

Laminectomy is a major undertaking, and rehabilitation is important parts of helping patients get a possible advantage from their surgery. Essentially, rehabilitation (physiotherapy, exercises) can help patients recover from laminectomy as quickly and entirely as possible.

Physiotherapy techniques may include:

  • Ice therapy or cryotherapy to help relieve pain
  • Heat therapy, to improve blood flow to the muscles and other soft tissues
  • Stretching, to reduce stress on joints
  • Exercise, to strengthen muscles
  • Manual therapy, including massage or soft tissue manipulation, to improve range of motion
  • Aquatic or pool exercises, to allow your body to exercise without pressure on the spine
  • Cycling and limited walking, to promote good physical conditioning
  • Education, to help you improve and maintain good posture

Benefits of active physiotherapy after laminectomy may include:

  • Learn how to stretch and exercise safely
  • Regain strength; become physically stronger
  • Become more fit and flexible; make it easier to move (e.g. walk, climb stairs)
  • Improved posture
  • makes stronger abdominal muscles; your body’s core center of strength
  • Be more sure-footed and improve balance, which can help prevent falls

Throughout your physiotherapy program, your physio keeps a record of your improvement and challenges. The progress with rehabilitation should be recorded and periodically shared with the doctor.

Have a question?

If for some reason an experienced doctor is not available around you, then you can contact us here.

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Considering Spine Surgery called Laminectomy?
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