Spinal Laminectomy Surgery In India
The operation normally takes approximately 2 hours. The skin layer is closed with either steri-strips, sutures or skin clips that will be removed at a later date. A large dressing will be placed over the incision for protection.
What is a Laminectomy ?
Laminectomy is a term used to describe operations on the spine where the bone surrounding the spine (the lamina) is removed. There are 7 laminae in the neck, laminectomy here being called a cervical laminectomy, 12 in the chest (thoracic laminectomy), and 5 in the lumbar region (lumbar laminectomy).
The procedure is performed under general anesthesia. A midline incision in the lower back is centered over the affected area. Dissection through the back muscles provides access to the spine. The portion of the vertebra known as the lamina is removed along with any thickened ligaments to release the nerves traveling down the center of the spinal canal. Individual nerves are released as they exit the spinal canal by shaving a portion of the degenerative facet joint. The soft tissues are then closed in multiple layers with absorbable sutures.
Why is a Laminectomy performed ?
There tend to be two broad reasons for a laminectomy: to relieve pressure on the spinal cord or the nerves emerging from it, or to allow access to the spinal cord in order to operate on it. An example of the first type is the common operation for a slipped disc.
Preparations needed for a Laminectomy
Some laminectomies are carried out as emergencies, perhaps for a problem causing rapid paralysis of the legs or arms. Others are carried out as planned procedures for slow deterioration in the limbs, or for pain. In emergencies, less time can be spent carrying out tests.
Possible Complications during a Laminectomy
All operations carry the risks of heart problems, stroke, chest and wound infections and leg thrombosis. Risks are higher, the older and sicker you are. The specific risks of laminectomy depend on the particular operation being carried out and will be discussed by the surgeon beforehand. When the spine is being operated on, there is a small risk that the spinal cord may be damaged and the patient ends up paralysed. The risks in the lumbar region for a slipped disc are very small. In the cervical or thoracic regions (especially for a tumour) they are higher. Normally high risk operations are not advised unless they are considered to be essential by the surgeon: the result of not having the operation may be paralysis.
After a Laminectomy
On recovery from the anaesthetic, observations of blood pressure, pulse and limb movement will take place at regular intervals for the first few hours. The back will be sore and regular painkilling injections or a painkilling drip will be given. Next day you will probably be able to eat or drink and the drip will be removed. Sometimes there is difficulty passing urine after the operation and a catheter is passed into the bladder, usually being left there until the you are up and about. The decision about when you can get up is made by the surgeon and usually depends on the type of operation.
Most surgeons like to get people mobile as soon as possible, sometimes even the next day after a simple procedure. Once up, you will have physiotherapy to stop the back stiffening up. Most patients go home within 2 weeks of surgery, their stitches coming out after 10 days. Most patients also require some physiotherapy. In some, a spinal (corset) support will be advised. It may be wise to avoid car driving until it is comfortable to do so.
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