Laminectomy: Indications and Complications

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The vertebral column forms a bony canal which protects the spinal cord. Formation of bony ingrowths, due to arthritis, from the vertebra into the spinal canal may lead to compression of the nerve roots leading to radiating pain. Laminectomy is a surgical procedure that removes the lamina, the back part of the vertebra over the spinal cord, hence alleviating the pain. Laminectomy is also called open decompression surgery.

Procedure of Laminectomy

Laminectomy is performed on an inpatient basis. After reaching the hospital you will be admitted. The anaesthesia team will prep you for the surgery. This procedure is performed under general anaesthesia. After the effect of anaesthesia sets in, the surgeon will make an incision in your back in the midline. The muscles attached to the lamina are carefully dissected from it. The lamina or the bony spur or the ligament leading to nerve entrapment is then removed. The facets forming the joint between the vertebrae may also be trimmed to provide more room for the nerve. Following this the skin and the muscle layers are sutured back into their place.

Indications for laminectomy

Your provider may suggest you undergo a Laminectomy when:

Medical and physical rehabilitation therapy yield unsatisfactory pain relief
Numbness and weakness interfere with daily routine activities
Symptoms of bladder and bowel incontinence are present.

Preparation for laminectomy

Your provider will like to record a detailed history of your illness and perform a physical examination. Test like x-ray and CT scan may be ordered to better localise the cause of the pain. Inform your doctor about the medications that you’ve been consuming then, your provider might ask you to stop some of them before the surgery. You will be asked to fast overnight before the surgery.

COMPLICATIONS OF LAMINECTOMY

The potential complications following a Laminectomy are:

Leak of the spinal fluid
Bleeding
Infection at the site of surgery
Nerve root damage
Bowel and bladder incontinence
Formation of blood clot in the leg that may dislodge from the leg and occlude a blood vessel in the long with disastrous consequences.

RECOVERY FROM LAMINECTOMY

Following the surgery you will be monitored as the effect of anaesthesia wears off. You might have to stay in the hospital for two to three days following the surgery. You will be encouraged to start walking on your own soon after the procedure. Before discharge you will be taught a set of exercises to strengthen and increase the mobility of your spine. Your provider will advise you to avoid strenuous activities which involve bending, lifting and twisting of the back for at least six weeks after the surgery. this provides adequate time for your back to heal.

SOURCES

https://orthoinfo.aaos.org/en/diseases–conditions/lumbar-spinal-stenosis/