 |
|
|
| h2u > Health Library |
View an animated version of this procedure:
A surgical procedure to remove a portion of a vertebra, called the lamina, under which one finds the
ruptured disc
that is pushing on nerves and causing pain and dysfunction. The ruptured disc is then removed. In other instances, the lamina is removed because of pressure caused by bony spurs or other pathology.
A laminectomy will affect the back, spinal column, and intervertebral disc.
Laminectomy is a surgical method of treating severe pain and disability resulting from compression of spinal nerves by a ruptured intervertebral disc or bony compression. Surgery becomes an option when persistent pain and disability have not been relieved by other means, such as rest, medications, or physical therapy.
The procedure is most often performed to treat progressive neurological problems, such as weakness, numbness, pain in an arm or leg, or loss of bowel or bladder control, due to nerve compression caused by:
- Pre-existing medical condition, particularly heart or lung problems
-
Obesity
- Advanced age
Your doctor will likely do the following:
- Physical exam
-
X-rays
-
MRI scan
—a test that uses magnetic waves to make pictures of the inside of the body and allows the spinal nerves and the intervertebral disc to be viewed
-
Myelogram
—a specialized type of x-ray that requires dye to be inserted near the spinal cord and shows if there is pressure on the cord or the nerves
-
Possibly a
CT scan
—a type of x-ray that uses a computer to make pictures of the inside of the body and can show the bones of the spine to see if there is room for the nerves and the spinal cord
In the time leading up to your procedure:
- If you are overweight, lose excess pounds to decrease the amount of stress on your back.
- Review your regular medications with the surgeon and follow instructions if asked to discontinue some drugs.
- Arrange for a ride to and from the hospital and medical appointments.
- Arrange for help at home after returning from the hospital.
- The night before, eat a light meal and do not eat or drink anything after midnight the night before unless told otherwise by your doctor.
IV fluids, anesthesia, and possibly a sedative
will be administered to you.
A
general
or spinal anesthesia may be used for a laminectomy.
Laminectomy can be done through a traditional, open incision, or via a laparoscopic technique, in which several small incisions are made, and a video camera and miniature surgical instruments are utilized. With either technique, the surgeon removes the lamina, which is the small part of the bone over the area where the nerve is being pinched. Once the bone is removed, the surgeon can see what is compressing the nerve, and will usually remove the offending disc.
If it is not a disc problem, the laminectomy allows the surgeon to look for other causes and decompress the area to reduce pressure on the nerves. Rarely, two adjacent vertebra (bones) may be joined together in a procedure called "spinal fusion." The incision is closed with stitches or staples.
A
laboratory will exam the removed tissue.
The surgery typically takes 1 to 3 hours.
Anesthesia prevents pain during surgery. You may experience pain during recovery but will receive drugs to relieve this discomfort. You may also feel numbness and tingling in your extremities that previously felt painful.
- Infection
-
Blood clots in a vein (
phlebitis
) or traveling to the lungs (embolism)
- Recurrent disc herniations
-
Damage to nerves, resulting in pain, numbness, tingling, or
paralysis
- Impairment of bladder function
- Anesthesia related problems
The length of stay is dependent on the anesthesia used and postoperative pain
but generally last 0 to 3 days.
- Expect to get up and walk with help the evening after surgery or the next day, possibly while wearing a back brace or support.
- Move and exercise your legs while in bed to improve circulation and decrease the risk of blood clots.
- Keep the incision area clean and dry.
- Stitches or staples will be removed in about two weeks.
- Only take medications recommended by your doctor; do not take over-the-counter remedies without your doctor's approval.
- Do not lift anything heavy.
Following the recommended activity and rehabilitation program will speed your recovery. At first, walking may be added to your home-rehabilitation program and, eventually, swimming or other low-impact exercises to improve your general physical condition and stamina.
Some achy pain in your back may persist. Continuing your exercise program and maintaining a healthy weight will help reduce this discomfort.
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
- Cough, shortness of breath, chest pain, or nausea or vomiting
- Weakness or paralysis that was not present in the hospital after surgery
- Loss of bowel or bladder function
- Numbness, tingling, pain, or weakness in any extremity or elsewhere in the body
Last reviewed November 2007 by
Rosalyn Carson-DeWitt, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition. Copyright © EBSCO Publishing. All rights reserved.
|
|
|
|
|
