Lumbar laminectomy

Lumbar Laminectomy


Laminectomy is a surgery performed to treat back pain by removing a lamina or bone spur 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 is it needed?

Laminectomy is recommended for people who suffer nerve root compression symptoms like:

  • 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

Causes of nerve root compression:

  • Spinal stenosis
  • Herniated disk
  • Cauda equine syndrome(CES) - loss of bowel and bladder control
  • Osteoarthritis
  • Tumour

Facts and Figures:

  • The 4th and 5th lumbar vertebrae discsare the most common site for operation foralmost 95% of surgeries.
  • An ancient Egyptian surgeon spoke about lumbar vertebral disorders in literature in 3000B.C
  • Dr. Victor Alexander Haden Horsley, professor of surgery at University College London, performed the first laminectomy in 1887.
  • Back pain ismore common in men thanwomen,and in adults between 45-64 years.
  • 1 in5 people are vulnerable to back pain, the leading cause of maximum missed work days, and 13 million people visit healthcare providers for the same reason every year.

Advantages:

  • Laminectomy improves quality of life by relieving back pain and increasing mobility.
  • One can regain lost control of bowel and bladder.

Disadvantages:

  • Long recovery time.
  • Chances of developing ‘Failed Back Syndrome’ with the possibility of additional surgeries.

Risks and Complications:

  • Reaction to anesthesia or medication
  • Infection or pain
  • Blood clots
  • Damage of the spinal nerveleading to paralysis later on

Pre-operative preparation:

  • Complete physical examination
  • Blood and urinalysis
  • Consult with the surgeona week prior and get the correct medicinal prescriptions.
  • Inform the surgeon about smoking and alcohol habits.
  • Plan for leave from work and domestic help at home.
  • Don’t consume anything after midnight before surgery.
  • Medical tourists are advised to wear comfortable clothes and select a handicap-accessible hotel room for recovery after gettingdischarged from the hospital.

Post-operative care:

  • One may need to stay at the hospitalunder medication for about 1-3 dayspost-surgery.
  • The hospital staff helpspatientsin walking around with a back bracewithin a day.
  • A physiotherapist will assistthem to ensure proper healing and restoration of function.

Precautions:

  • Take medicines and perform exercises as prescribed by the surgeon and physiotherapist respectively.
  • Keep the incision area dry and clean
  • Avoid strenuous activities and twisting at the hips and shoulders for 6-8 months
  • Use arms to support the body while getting out of bed
  • Avoid waist banding
  • Lie on the back with a pillow under neck and knee