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Overview
Laminectomy, also known as decompression surgery, is performed on the spinal vertebrae to release pressure from the spinal nerve or cords. It is essentially the surgical removal of the lamina; the back part of the vertebra that covers your spinal canal. This removal causes the spinal canal to have more space and release the pressure that originates in the spine.
The pressure can be due to bony outgrowths within the spinal canal, normally seen in people with arthritis in their backbone. These bony extensions are also observed in senior citizens and are more or less regarded as a common age-related occurrencein these populations.
Laminectomy is applied by the surgeon when all conventional treatments like medicine, physiotherapy, and injections have failed. This technique is also used when the symptoms worsen or deteriorate very fast.
Why it's done
Bony overgrowths can encroach upon the space occupied by the spinal nerves and cords, resulting in severe pain, numbness, or weakness that is known to spread to the arms or legs. Laminectomy is a procedure that relieves the compression occurring in the spinal nerves, which can improve on the symptoms but it is not a way of curing arthritis already present. Some of the reasons that can be enough to go for a laminectomy by your doctor are;
(i). Traditional treatments like medicines, physiotherapy, and pain-relieving injections have become ineffective.
(ii). You have muscle weakness or numbness that makes standing or walking a difficult task.
(iii).You may experience complete or partial loss of bowel control.
In some situations, laminectomy may be needed to perform at first like when operating for a herniated disk. The doctor may opt to remove the lamina before attending to the damaged vertebral disk.
Causes
The causes that require a laminectomy surgery are usually the ones that cause injury in the vertebral column in the first place. The whys and wherefores that may require the physician to opt for this surgical intervention may be stated as;
• Violent bodily attack: Spinal injury may occur due to a brutal attack such as a stabbing or a gunshot, and may require stabilization surgery to correct the deformity caused. Usually, a fracture or contusion will occur at the site of injury. Laminectomy may be done to access the injury site.
• Upper body trauma: Sudden and violent shock to the face, cranium and collar region, back, or torso area may cause problems in the spine which may need treatment and preparatory surgery by laminectomy.
• Falling from a great height: This is the same as the jumping into a shallow pool. The forceful contact with the ground may cause injuries to the spine, to be corrected by laminectomy.
• Electrical mishaps: Often, electrical shockwaves may cause a person to get viciously thrown across space. The landing on the hard surface may cause shock to the spinal column and necessitate the laminectomy surgery before others to make better.
• Extensive flexible movement: This condition may arise due to unexpectedinjuries during weight training, unmonitored yoga or car accident, which may cause injury to the spinal column. The only way of treatment can be a stabilization surgery, often preceded by a laminectomy.
• Old-age: Spinal compression may occur due to the development of bony outgrowths in old-age. Laminectomy procedure shall be applied to correct this condition
SYMPTOMS
The signs and indications of compression in the bone will be similar to the injuries or reasons your doctor may think of laminectomy to cure your symptoms. The doctor will decide on the mode of treatment after the correct diagnosis and identification of the source of the problem.
(i). Pain in the back
(ii). Pain that escalates on physical activity but reduces when taking rest.
(iii). Having trouble winding or twisting your body.
(iv). Loss of height
(v). Change in the shape of your backbone.
(vi). Bending of the spine or kyphosis.
(vii). Compression on the digestive organs.
(viii). Constipation
(ix). Feeble appetite
(x). Loss of weight
(xi). Pain in the hips.
(xii). Difficulty in breathing
DIAGNOSIS
The damages of the spine are analyzed by different imaging techniques primarily; although, in some cases, a test of balance and nerve functions may be essential to comprehend the problems. The different methods which can help your physician recognize the state of your spine and prescribe a laminectomy surgery may be listed as;
• CT scans
A computerized tomography scan (CT or CAT scan) uses computers and a circling X-ray machine to create cross-sectional images of the body. These pictures provide more detailed and in-depth information than ordinary X-ray images. They are used to picture the soft muscles, blood vessels, and bones in numerous parts of the body.
• MRIs
This system uses a high-intensity magnetic field to create a three-dimensional image of the body. This technique can show the detailed situation and state of the spinal injury.
• X-rays
This is a recognized method in which lights of lower wavelength are used that pierces the soft tissues and shows an image of the inner bones and joints.
• Evoked potential testing
This is a test which processes how quickly nerve signals reach the brain so that the first indication and a concept of the extent of nerve injuries can be apprehended by the surgeon so that he or she can take knowledgeableconclusions about the surgery.
RISK FACTORS
Laminectomyrequires the exposure of the vertebral column so some risks are there. Some of the risks may include:
• Bleeding
• Infection
• Blood clots
• Nerve injury
• Spinal fluid leak
• Problems in the digestive system.
POST-OPERATIVE CARE
• The doctor may give you bed rest for two-three days.
• Some pain is normal and treatable by painkillers and antibiotics.
• Braces may be arranged by the doctor in charge to keep the alignment of your spine correct.
• You may be given physiotherapy to accelerate the healing process and maintaining the orientation of the spine.
• Mild exercises may be given to ensure the upkeep of functions.
• Restraint may be placed on lifting heavy objects for some time for the patient.
The total procedure will take about 8-10 days.
TREATMENT
After it has been established that the treatment shall now proceed only by surgery, the physicians will organize you for the upcoming operation. The guidelines the physician may give you to follow before and during the procedure are:
Before the treatment
The hospital staffs will check for your case history, any alcohol or drug use, previous medical histories, any allergies,etc. Then they will check for any difficulties in your pulse or blood pressure. Several images of your spine will be taken before the operation.
Before the procedure, you will be given anesthesia at the position of the incision or will be made fully unconscious according to the type of surgery determined by the physician. Any personal items like jewelry, piercings, dentures, contact lenses will have to be detached during the procedure.Preparation before the procedure may comprise of shaving the hair over the operating site. The surgical team may give you antibiotics to monitor the growth of unhealthy microorganism.
During the surgery
• You will be placed in a position with the chest facing down on the operating table.
• The part where the incision is made will have body hair shaved off.
• You will be given anesthesia locally or will be made fully knocked out.
• The faulty bone with the bony outgrowth will be identified.
• The lamina will be surgically removed.
• Metal plates, screws or rods may be used to help secure the vertebrae in place together if a vertebral fusion has to be done.
FACTORS AFFECTING COST
The rate of the treatment may be governed by the following features:
i. The charges of the instruments
ii. The price of medicines
iii. The surgeon charges
iv. The hospital room cost used during the recuperation
FAQ
After the surgery is complete, the patient may take 2-3 weeks to return to normal life. If a spinal fusion is also included, then the time may increase.
No, it is general surgery and the incisions done will be covered up.
Yes, in some cases, leg pain is seen in the patients having laminectomy.
You can resume walking 2 to 3 weeks after laminectomy procedure. Start with short trips to avoid straining the area operated on.
