What is Laminectomy?
Laminectomy is a procedure to remove the lamina, which is a part of the spinal canal’s bony structure. The spine surgery is performed to relieve pressure on one or more spinal nerve roots. This pressure, often called nerve root compression or “pinched nerve “ may be the cause of back pain and leg pain.
This may involve:
Nerve root compression may be caused by:
- Ruptured disc - Also called a protruded, slipped or herniated disc
- Spondylosis - Deterioration or “wear and tear” of multiple discs with bony spur formation and degenerative disc
- Scar tissue
- Combination of the above factors
How is this spine surgery performed?
Laminectomy is performed with the patient lying faced down after general anesthesia. A portion of one or more vertebra is removed in order to reach the compressed nerve root(s). Once the point of nerve root compression is located; the source of the pressure is removed.
This may involve:
- Removing the ruptured portion of the disc
- Removing the bony spurs and bony overgrowth
- Removing the scar tissue.
The spine surgery takes approximately 1.5 to 3 hours. Sometimes, a plastic drain is left in the wound for a few days after the operation to drain any blood that may have collected under the wound. Post-operatively, patients are in the hospital for 4-5 days. The patient's ability to return to normal activity is largely dependent on his/her pre-operative condition and age. Patients are encouraged to resume walking; however, it is recommended to avoid excessive bending, lifting or twisting for six weeks in order to avoid pulling on the suture line before it heals.
Why is it done?
One of the most common reasons for laminectomy is intervertebral disc herniation. If the herniated disc is in the lumbar region, this can cause sharp and continuing back pain, a weakening of the muscles in the leg, and some loss of sensation in the leg and foot. It may also be difficult to raise the leg when it is held in a straight position. A herniated disc in the neck region can cause symptoms including pain, numbness and weakness in the arm. A herniated disc may be triggered by twisting the back while lifting something heavy. During the spine surgery, the surgeon will attempt to relieve the pressure on nerves and nerve roots by removing the pulpy material that is protruding from the disc.
Risks & complications
Complications are infrequent and usually minor. However, as with any spine surgery, there are risks, including the possibility of:
- Nerve root damage or bowel/bladder incontinence.
- Paralysis would be extremely unusual since the spinal cord stops at about the T12 or L1 level, and surgery is usually done well below this level.
- The cerebrospinal fluid leak may be encountered if the dural sac is breached. This does not change the outcome of the surgery, and generally a patient just needs to lie down for about 24 to 48 hours to allow the leak to seal.
- Infections could happen; however, it generally can be managed and cured effectively.
- Re-herniation of the same disk
Risks from any surgery can be reduced by following the surgeon's instructions before and after the back surgery.
Alternatives to spine surgery
The surgeon may discuss alternative approaches to the laminectomy procedure such as weight loss and use of medication to relieve pain. Physical therapy and orthopedic braces may aid in decompressing or mobilizing the spine using non-invasive or mechanical techniques.
The candidates for laminectomy are those who suffer from chronic pain and do not respond to medication and physical therapy. The surgeon will make the final determination of each patient’s eligibility for the procedure after examinations and consultations with the patient.
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