Laminectomy is a surgery involving the removal of the lamina, which is the portion of the vertebrae that surrounds the spinal canal. It is located on the posterior portion of each vertebra. The removal of the lamina enables the spinal canal to widen to relieve pressure on the nerves and spinal cord; thereby, it is also known as decompression surgery.
Laminectomy is by far the final resort for conditions that cause compression of the spinal cord and underlying nerves such as disc herniation, spinal stenosis and other problems involving the spine.
Why is Laminectomy Indicated?
As a last resort, laminectomy is only used when conservative treatments like physical therapy and medications deemed inadequate to relieve the symptoms or the symptoms keep getting worse. Symptoms of nerve and spinal cord compression requiring laminectomy may include numbness and tingling sensations in the arms and/or legs, pain and weakness of the limbs. Laminectomy is also indicated if the symptoms make it difficult for someone to move, walk or stand, which means that the spinal cord and the underlying nerves are severely entrapped needing surgical measures to relieve the nerve compression. Furthermore, loss of bladder or bowel control may indicate an emergency situation requiring laminectomy immediately to avoid permanent nerve damage.
How to Prepare for the Surgery
Laminectomy is performed after adequate pre-operative preparation is employed. Patients for surgery are required to take nothing by mouth (food and drinks) at least 8 hours prior to the surgery. This will ensure that no untoward events will happen during the surgery such as aspiration of gastric contents to the lungs and the like. Surgeons will also give specific instructions regarding other preparations.
How is Laminectomy Performed?
During the procedure, patients are under general anesthesia. The vital signs are continuously monitored to ensure a stable condition during the operation. When the anesthesia has been inducted and the effects are evident, an incision is made on the back at the level of the affected spine. The most common sites are the neck and the lower back area because these are the common sites for narrowing of the canal. The incision cuts through the muscles until the spinal column is exposed. The lamina is then removed to widen the spinal canal.
When herniated disc is present, the bulging disc may also be dissected. When abnormal curvature such as severe scoliosis is present, there may also be spinal fusion to correct the deformity and prevent the worsening of the condition. When the surgery has been completed, the incision is stitched or stapled.
What to do after the Surgery?
Immediately after the operation, patients are monitored in the recovery room until the patient is stable and the arms and legs can be moved. Patients should also be positioned on their side to prevent pressure on the operative site. A prone position or lying on the abdomen is not employed because this position may misalign the spine contributing to further complications.
Following laminectomy, heavy works such as lifting should be avoided for several weeks. Stooping, bending, overreaching and twisting at the waist should also be avoided.
Complications of Laminectomy
In every surgical procedure, there are always risks involved and laminectomy is not exempted. Risks and complications that may arise include infection, bleeding and blood clots due to the physical trauma during the operation. There can also be spinal fluid leak as well as nerve injury when the underlying nerves and spaces are severed. Nevertheless, laminectomy is generally safe when performed by trained surgeons.
Laminectomy is always the last treatment for spinal conditions involving nerve compression. In this line, more conservative approaches such as medications, physical therapy and the like should be used first to manage any condition.