Laminectomy: Types, Procedure, and Risks

Laminectomy: Types, Procedure, and Risks

Laminectomy is a surgery done to relieve pain due to spinal cord compression. The pressure over the spinal cord can arise because of some overgrowth known as bone spurs. It can cause pain, weakness, or numbness that goes down to the arms or legs. 

To perform a laminectomy, the surgeon removes the lamina of the person. Lamina is a bone that forms the vertebral arch over the spine. By performing laminectomy, the spinal canal enlarges and thus relieves pressure over the spinal cord.

Types of laminectomy

There are various types of laminectomy surgeries. These are:

• Cervical laminectomy: The surgeon performs this surgery on the cervical vertebra in the neck.
• Lumbar laminectomy: This surgery involves the vertebrae in the lower back. It helps relieve pain in the lower back, buttocks, and legs.
• Sacral laminectomy: This is the removal of the lamina in the back between the pelvic/hip bones.

What are the reasons we require laminectomy?

Doctors recommend laminectomy if there are signs of a herniated disc or spinal stenosis. Spinal stenosis occurs when pressure arises in the spinal cord because of overgrowths in the spinal canal. And herniated disk occurs when the soft tissue between vertebrae pushes through a crack inside the spine.

In such conditions, there are various symptoms to look out for. These are:

• Pain in the neck or lower back.
• Numbness, aching, or tingling sensation in arms and legs.
• Cramps or weakness in the hands, arms, legs, or feet.
• Difficulty in walking.
• Difficulty controlling bladder or bowel movements.
• Spine arthritis 
• Spinal injuries 
• Herniated or slipped disks
• Tumors inside the spinal canal
• Bone spurs inside the spinal canal

Diagnosis of laminectomy

Mostly aging is the major cause for doing laminectomy. To find out the underlying reason, various tests can prove helpful. These are:

• Plain spinal x-rays
• Myelogram test
• Computerized tomography (CT) scan
• Magnetic resonance imaging (MRI) scan

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Procedure for Laminectomy

During the laminectomy, the surgeon will disinfect and make the required incision (cut) over the skin. The skin, muscles, and ligaments are carefully moved sidewards to reach out to the spinal area. After that, lamina bone is cut, and misaligned vertebrae are corrected. If required, bone spurs are also removed. The incision is then closed with stitches after placing skin, ligaments, and muscles correctly.

What to expect post-surgery?

After the surgery, doctors may  ask you to walk on your own. Usually, the patient can go home the same day, but hospitalization for 1-3 days is also normal. For the coming few weeks, the patient should have rest and avoid:

• Bending over or twisting the spine.
• Driving and operating heavy machinery
• Lifting, pushing or pulling heavy objects.
• Engaging in any rigorous exercise.

The person should stick to the doctor’s prescription to have a speedy recovery. Ask the doctor or nurse to guide you on the proper cleaning procedure for the incision and stitches.

Risks involved in a laminectomy

All surgeries have certain risks. The surgeon should take care of the following:

• Blood loss
• Wound pain
• Muscle, ligament, or nerve damage
• An infection in the surgical area
• Blood clot
• Breathing difficulty
• An allergic reaction

Complications involved in a laminectomy

Although laminectomy rarely leads to any severe complications but nerve roots injuries and dural tears can take place. It is more common in old people.

Cerebrospinal fluid (CSF) will leak out of tears in the dura mater (the thick membrane surrounding the spinal cord). It is a serious issue that causes additional complications, like dizziness, headaches, and seizures.

Some other complications include:

• Unsuccessful treatment that can cause recurring symptoms.
• An infection in the incision
• Damage to the nerves, muscles, or tendons near the spine.
• Back pain

Self-Care after laminectomy

Always be in continuous guidance with your doctor. But a few self-care suggestions are:

• Continue your medications as prescribed by the doctor.
• Avoid activities that could strain the spine, such as sitting or standing for too long, flexing your spine, bending at the waist, climbing too many stairs, or going for long trips in the car.
• Avoid wearing high-heels.
• Sleep on a firm mattress.
• Practice exercises you were recommended in the hospital. Gradually increase them, but stop if you feel any pain.
• Have light physiotherapy sessions.
• Report any signs of infection, high temperature, or continuous headache to your doctor.

Conclusion

Laminectomy is a surgery that will have a positive outcome and relieve you from pain. But, it is of prime importance to know the main underlying cause for such a condition. In most cases, this surgery is done with no complications, but some complications can occur only with very old people.

Frequently Asked Questions (FAQs):

How do I prepare myself for laminectomy?

Discuss your full medical history with the doctor. Any allergies or medications should be disclosed to the doctor. Also, try not to smoke and consume alcohol just before surgery.

Are there any long-term side effects of a laminectomy?

There are no side effects of laminectomy. But sometimes, it cannot fully relieve pain in the spine. People with spinal fusion are likely to have such problems.

How soon can I go home after surgery?

Normally, the patient can return home the same day after the surgery. But, if the medical condition requires monitoring, you can be hospitalized for 1-3 days.