Lumbar & Cervical Laminectomy
Lumbar Laminectomy
Lumbar laminectomy, also known as decompression laminectomy, is a spinal surgery done to relieve excess pressure on the spinal nerve(s) in the lumbar (lower back) region.
The term laminectomy originated from the Latin word ‘lamina’ refers to a thin plate and the word ‘ectomy’ means removal. The purpose of laminectomy is removal of the lamina or roof of the vertebra so as to provide enough space for the nerves to exit the spinal canal (decompression).
Indication
Spinal stenosis is one of the major indications for lumbar laminectomy. It is a condition of narrowing of spinal canal due to arthritic changes of facet joints and intervertebral discs. This causes enlargement of the joint that exerts pressure on the spinal nerves.
Symptoms of nerve impingement are back pain or radiating pain into the hips, buttocks or legs, numbness or tingling sensation and muscle weakness in the back and lower extremities.
Procedure
Lumbar laminectomy is usually performed under general anesthesia. In this technique, the patient lies face down on the operating table. A small incision is made along the midline of the back. To have a clear view of the spine, the surgeon slowly retracts the soft tissues and muscles. A part of or the entire lamina is removed to eliminate the pressure on the nerve roots. In addition, other sources of compression such as bone spur or damaged disc is removed to relieve the symptoms. At the end of the procedure, the surgeon realigns the soft tissues and the incision is closed.
Post-operative Instructions
Following a laminectomy, you may observe an immediate improvement of some or all symptoms or sometimes a gradual improvement of the symptoms.
The duration of hospitalization depends on the treatment rendered. At the end of the first day of the surgery you are allowed to move and walk around the hospital. Returning back to your daily life or to work depends on how well you are healing and the type of work or activity level.
Strictly follow the post-operative instructions suggested by your spine surgeon to promote healing and reduce the risk of post-operative complications.
Complications
The complications of the lumbar laminectomy include infection, nerve damage, blood clots, blood loss, bowel and bladder problems and any problem associated with anesthesia.
Talk to your surgeon if you have queries regarding lumbar laminectomy.
Cervical Laminectomy
A cervical laminectomy is an operative procedure of removing the bone at the neck (cervical spine) region to relieve pressure on the spinal nerves. It can also be performed to relieve the symptoms of narrowed spinal canal known as spinal stenosis.
Laminectomy refers to removal or cutting of the lamina (roof) of the vertebral bones to provide space for the nerves to exit from the spine.
Indication
Degeneration of the facet joints and intervertebral discs results in narrowing of the spinal canal known as spinal stenosis. In addition, the arthritic facet joints become bulkier and consume the space available for the nerve roots. Besides, bony out growths also known as bone spurs or bone osteophytes can also narrow the spinal canal. This condition of spinal stenosis, narrowing of the spinal canal, puts pressure on the spinal nerves and spinal cord, causing symptoms such as neck pain, tingling sensation, numbness or weakness that extends to the shoulders, arms and/or hands, and bowel or bladder impairment.
The objective of cervical laminectomy is to relieve pressure on the spinal nerves by removing the part of the lamina that is putting pressure on the nerves. Your surgeon recommends you for cervical laminectomy after examining your spine, medical history, and imaging results of cervical vertebrae from X-ray, CT (computed tomography) scan or MRI (magnetic resonance imaging). Surgery is recommended only after non-surgical treatment approaches fail to relieve symptoms after a reasonable period of time.
Procedure
The procedure is performed with you resting on your stomach and injected with sleep inducing medication (general anesthesia). Your surgeon makes a small incision near the center of your neck on the back side, and approaches the neck bones (cervical vertebrae) by moving the soft tissues and muscles apart. Then, the total lamina or a part of the lamina is removed to relieve the compression. Other compression sources such as bone spurs and/or disc fragments (discectomy) are also removed. After the procedure, your surgeon brings back the soft tissues and muscles to their normal place and closes the incision.
In some instances, spinal fusion may also be done along with the cervical laminectomy which involves placing bone graft or a bone graft substitute between two affected vertebrae to allow bone growth between the vertebral bodies. The bone graft acts as a medium for binding the two vertebral bones, and grows as a single vertebra which stabilizes the spine. It also helps to maintain the normal disc height.
Post-operative Recovery
A specific post-operative recovery/exercise plan will be given by your physician to help you return to normal activity at the earliest. After surgery, your symptoms may improve immediately or gradually over the course of time. The duration of hospital stay depends on this treatment plan. In a few instances, surgery may also be performed on an outpatient basis. You will be able to wake up and walk by the end of the first day after the surgery. Your return to work will depend on your body’s healing status and the type of work/activity that you plan to resume. Discuss with your spinal surgeon and follow the instructions for optimized healing and appropriate recovery after the procedure.
Risks or Complications
All surgeries carry risk and it is important to understand the risks of the procedure in order to make an informed decision to go ahead with the surgery. In addition to the anesthetic complications, spinal surgery is associated with some potential risks such as infection, blood loss, blood clots, nerve damage, and bowel and bladder problems. Failure to fuse the vertebral bones with the bone graft (fusion failure) is an important complication of spinal fusion which requires an additional surgery.
Please take your physician’s advice for a complete list of indications, clinical results, adverse effects, warnings and precautions, and other relevant medical information about cervical laminectomy procedure.
