Laminectomy And Discectomy

Laminectomy And Discectomy

Is a laminectomy a major surgery?

How long does it take to recover from a laminectomy?

What is the success rate of a laminectomy?

 

· Laminectomy

Back pain that interferes with normal daily activities may require surgery for treatment. Laminectomy is a type of surgery in which a surgeon removes part or all of the vertebral bone (lamina) to relieve compression of the spinal cord or the nerve roots that may be caused by injury, herniated disk, spinal stenosis (narrowing of the canal), or tumors. A laminectomy is considered only after medical treatments have proven to be ineffective.
Other related procedures that may be used to help diagnose back problems include CT scan, X-ray, MRI, electromyogram (EMG), and myelogram. 

Read more about: Laminectomy Surgery Procedure

Read more about: Laminectomy Surgery Back Pain

Reasons for the Procedure

Low back pain can range from mild, dull, annoying pain, to persistent, severe, and disabling pain. Pain in the lower back can keep you from moving and get in the way of your daily life. Laminectomy may be needed to relieve pressure on the spinal nerves, treat a disk problem, or remove a tumor from the spine.

One common reason for having a laminectomy is a herniated disk in the spine. A disk may be moved or damaged because of injury or wear and tear. When the disk presses on the spinal nerves, this causes pain, and sometimes numbness or weakness. The numbness or weakness will be felt in the body part where the nerve is involved, often the arms or legs. The most common symptom of a herniated disk is sciatica. Sciatica is a sharp, shooting pain along the sciatic nerve which runs from the buttocks to the thigh and down the back of the leg.

If medical treatments don’t help, back surgery may be a good option. Laminectomy is usually done when back pain that continues after medical treatment, or when the back pain is accompanied by symptoms of nerve damage, such as numbness or weakness in the legs.

There may be other reasons for your health care provider to recommend a laminectomy.

Before Your Laminectomy

Before your laminectomy, you should receive detailed instructions on how to prepare from your surgeon's staff during one of your office visits. Here's what you should do and plan for before the surgery:

  • Don't eat or drink anything after midnight the night before your laminectomy.
  • Wear loose, comfortable clothing. Don't wear jewelry, especially necklaces or bracelets.
  • Bring your insurance information and your pocketbook for any co-payments or required paperwork.
  • If your doctor thinks you might be able to go home the same day, bring someone to drive you home and help take care of you.
  • Plan for being slow for a while. Stock up on groceries and take care of all the errands and housekeeping you can.
  • Let friends and family know you'll be having surgery; you'll be able to use extra help during your recovery.

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During the laminectomy

A laminectomy usually requires a stay in a hospital. Procedures may vary depending on your condition and your doctor’s practices.

A laminectomy may be performed while you are asleep under general anesthesia, or while you are awake under spinal anesthesia. If spinal anesthesia is used, you will have no feeling from your waist down. Newer techniques are being developed that may allow a laminectomy to be done under local anesthesia on an outpatient basis. Your doctor will discuss this with you in advance.

Generally, a laminectomy follows this process:

  • You will be asked to remove clothing and will be given a gown to wear.
  • An intravenous (IV) line may be started in your arm or hand.
  • Once you are under anesthesia, a urinary drainage catheter may be inserted.
  • If the surgical site is covered with excessive hair, the hair may be clipped off.
  • You will be positioned either on your side or abdomen on the operating table.
  • The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
  • The skin over the surgical site will be cleansed with an antiseptic solution.
  • The surgeon will make an incision over the selected vertebra.
  • The surgeon will spread the back muscles apart.
  • The lamina (bony arch of the posterior part of the vertebra) is removed to relieve the pressure on the nerves in the area. This may involve removing bone spurs or growths, or removing all or part of a disk.
  • In some cases, spinal fusion may be performed at the same time. During a spinal fusion, the surgeon will connect 2 or more bones in the back to help stabilize the spine.
  • The incision will be closed with stitches or surgical staples.
  • A sterile bandage or dressing will be applied.

Read more about: Laminectomy Success Rate

Read more about: Is a Laminectomy a Major Surgery

·         Diskectomy

Diskectomy is a surgical procedure to remove the damaged portion of a herniated disk in your spine. A herniated disk can irritate or compress nearby nerves. Diskectomy is most effective for treating pain that radiates down your arms or legs.

The procedure is less helpful for treating actual back pain or neck pain. Most people who have back pain or neck pain find relief with more-conservative treatments, such as physical therapy.

Your doctor may suggest diskectomy if conservative, nonsurgical treatments haven't worked or if your symptoms worsen. There are several ways to perform a diskectomy. Many surgeons now prefer minimally invasive diskectomy, which uses small incisions and a tiny video camera for viewing the procedure.

Why it's done

A diskectomy is performed to relieve the pressure a herniated disk (also called a slipped, ruptured or bulging disk or disk prolapse) places on a spinal nerve. A herniated disk occurs when some of the softer material inside the disk pushes out through a crack in the tougher exterior.

Your doctor may recommend diskectomy if:

  • You have trouble standing or walking because of nerve weakness
  • Conservative treatment, such as physical therapy or steroid injections, fails to improve your symptoms after six to 12 weeks
  • Pain radiating into your buttocks, legs, arms or chest becomes too much to manage
  • Injury to blood vessels or nerves in and around the spine

Is a laminectomy a major surgery?

Laminectomy is a common but major surgery with significant risks and potential complications. You may have less invasive treatment options available. Consider getting a second opinion about all of your treatment choices before having a laminectomy.

Read more about: Cervical Laminectomy

Read more about: Laminectomy Complications

How long does it take to recover from a laminectomy?

It depends on the extent of your surgery and your situation. After a minor (decompressive) laminectomy, you can usually able do desk work and light housekeeping within a few days to a few weeks. If you also had spinal fusion, your recovery time will likely be longer, 2-4 months. You may not be able to lift and bend for 2-3 months. Start light walking for exercise and physical therapy exercises as soon as your doctor says you're ready. This will help speed your recovery.

You may not know if your back pain is better until 6 weeks or more after the surgery.

What is the success rate of a laminectomy?

Laminectomy is generally a safe procedure. But as with any surgery, complications may occur.  Laminectomy has about an 80 percent success rate at improving walking abilities.

Read more about: Lumbar discectomy surgery

Read more about: Laminectomy Surgery Position

 

10 common questions about Laminectomy And Discectomy

1Is laminectomy and discectomy the same thing?
These facet joints become enlarged and put pressure on nerves. Lumbar laminectomy is performed to remove the bone and bone spurs and repair ligaments that may be compressing the nerve. While the procedure can be done using traditional open surgery, more orthopaedic surgeons are opting for minimally invasive surgery.
2What is the difference between laminectomy and Hemilaminectomy?
The lamina is a bony protective covering at the back of your spinal canal. The difference between laminectomy and laminotomy is straightforward: A laminectomy is the total removal of the lamina; a laminotomy is the partial removal of the lamina
3Is it normal to have leg pain after laminectomy?
Sometimes this is a temporary condition as the nerve root or roots take time to heal. This can take days to weeks. If the pain is still there after 3 months, it is unlikely to improve on its own. Below are a few reason why leg pain may persist after surgery.
4How long does it take to recover from laminectomy and discectomy?
In general, here's what to expect: After a minor (decompressive) laminectomy, you are usually able to return to light activity (desk work and light housekeeping) within a few days to a few weeks. If you also had spinal fusion with your laminectomy, your recovery time will likely be longer -- from two to four months.
5Does laminectomy weaken the spine?
Pain in the spine can restrict your ability to move and function. Laminectomy may be done to ease pressure on the spinal nerves, treat a disk problem, or remove a tumor from the spine. One common reason for having a laminectomy is a herniated disk in the spine. ... The most common symptom of a herniated disk is sciatica.
6How many hours does a laminectomy surgery take?
The skin is closed using stitches or surgical staples. A sterile bandage is applied, and is changed daily while in the hospital. The total surgery time is approximately 1 _ to 3 hours, depending on the number of spinal levels involved. Most patients are usually able to go home 2-5 days after surgery.
7Is the lamina replaced after a laminectomy?
After a laminectomy, the “roof” of the spinal canal can be left open; the lamina does not need to be replaced by a plate or bone graft.
8Does the bone grow back after a laminectomy?
Years after decompression (lumbar laminectomy), lumbar stenosis can come back (the bone can grow back) at the same level, or a new level can become stenotic and cause back pain or leg pain. ... Failed Back Surgery Syndrome (FBSS): What It Is and How to Avoid Pain after Surgery.
9Can a laminectomy be done twice?
In essence, a revision laminectomy is the same procedure as a standard laminectomy. It is simply being performed for a second time. ... Because a laminectomy can only treat the symptoms of this condition, rather than the cause, regrowth is not only possible, but likely in many circumstances.
10What can go wrong with a laminectomy?
Anxiety, depression, and other mental health issues prior to a laminectomy surgery may result in poor surgical outcomes. These conditions may cause poor patient compliance, poor adherence to post-surgical rehabilitation programs, and lower pain tolerance.

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