Definition:
Laminectomy is a surgery performed to treat the back pain by removing a lamina or bone spure of the spinal vertebrae; this reduces the compression or pressure on the spinal nerve root. The most common laminectomy performed to relieve lower back pain is called Lumbar laminectomy.
Why it is needed:
Laminectomy is advised to patients who suffers various symptoms caused by nerve root compression that includes:
- Severe leg pain
- Numbness, tingling and weakness of the legs or buttocks
- Aggravation of pain and symptoms while standing or walking
- Poor bowel and bladder control
- Symptoms not relieved by medication or other conservative treatments and affecting the routine daily life of the patients
The cause of nerve root compression could be:
- Spinal stenosis
- Herniated disk
- Cauda equine syndrome(CES)- includes loss of bowel and bladder control
- Osteoarthritis
- Tumor
Facts and Figures:
- The 4th and 5th lumbar vertebrae disc is the most common site for the operation counting almost 95% of surgeries.
- An ancient Egyptian surgeon had mentioned about disorders affecting the lumbar vertebrae in the literature, in 3000B.C
- The credit of performing first laminectomy goes to Dr. Victor Alexander Haden Horsley in 1887, who was a professor of surgery at University College London.
- Today, back pain had become the leading cause for maximum missed work days
- Back pain is found more common in men than women , affecting adults mostly between the age of 45 to 64 years
- Each year 13 million people visit the health care provider for the complain of back pain
- Approximately one person in every five is prone to suffer from some kind of back pain.
Advantages and Disadvantages:
Advantages
- Laminectomy gives patient relief from chronic back pain and other symptoms of leg
- Improves the quality of life of patient.
- Patient becomes more mobile and active at work place.
- One can regain the lost control of bowel and bladder.
Disadvantages
- Surgery requires longer recovery time.
- Chances of developing “Failed Back Syndrome”
- Additional surgeries may require if the first surgery fails to relieve symptoms
Risks and Complications:
- Reaction to anesthesia or medication
- Infection
- Blood clots
- Bleeding
- Damage of the spinal nerve, can lead to paralysis in later stage
- Return of pain or symptoms
Pre-operative and Post-operative care:
Pre-operative preparation:
- A complete physical examination
- Blood and urinalysis
- X-rays, MRI and CT Scan
- Visit to a physician and have a list of the medicines which are to be taken or needed to be stopped before surgery
- Inform surgeon related to any habits of smoking or alcohol. Quit smoking.
- Arrangement for leave from work, help at home, help with driving, and for post operative rehabilitation
- Do not eat or drink anything after midnight the night before surgery
- Medical tourist are advised to select handicapped accessible hotel room near the hospital for post surgery recovery
Post-operative care:
- Patient may need to stay at hospital for about 1-3 day after the surgery. Medication to relieve pain will be given.
- The hospital staff will help patient to get up and walk around within a day after surgery. Patients may need to wear a back brace.
- A physical therapy will help patient to ensure proper healing and restoration of function
Do’s, Don’ts and Precautions
- Take the medication as prescribed by the surgeon regularly
- Do perform the exercise regularly, as taught by the physical therapist
- Do keep incision area dry and clean
- Avoid strenuous activities for at least 6 to 8 months
- Avoid twisting at the hips and shoulders
- Use arms to support body while getting out of bed
- Avoid waist banding
- Do lie on back with putting pillow under neck and knee
