Neck and back pain can be far more than just an annoying discomfort. Many people who struggle with neck and back pain find it impacts their overall quality of life. In some of these cases, a special type of surgery known as a Laminectomy might be able to help. Especially if the underlying cause of your neck or back pain is associated with pressure placed on the spinal column and root nerves from an injury, spinal stenosis, herniated disc, tumor or similar structural defects.
Though it’s worth noting that a Laminectomy is rarely the first line of treatment. Instead many physicians see this surgical procedure as being a fallback treatment plan after other measures have clearly failed to produce net positive results.
When Is Laminectomy Indicated?
As a fallback or last line of treatment strategy, a Laminectomy is typically indicated when other treatment methods have failed, or when the underlying cause of neck and back pain is accompanied by symptoms of nerve damage. This might include things like numbness or weakness in the arms and legs. Other nerve damage conditions that could indicate the need for a Laminectomy might also include the loss of bladder or bowel control caused by pressure in the nerves of the lumbar or cervical spine.
What Are The Risks Of A Laminectomy?
Just like any invasive surgical procedure a Laminectomy comes with some risk. This includes things like:
- Post-operative bleeding & risk of infection
- Blood clots developing in the legs
- Blood clots traveling from extremities to the lungs
- Spinal cord injury
- Nerve root injury
It is also possible for a Laminectomy to affect the nerve and blood vessels in the surgical field. This has the potential to cause numbness and weakness in the surrounding tissues and extremities.
How To Prepare For A Laminectomy?
With any surgical procedure proper preparation will play a factor in the success of the treatment process. Be sure to let your physician know about any and all medical conditions, as well as other medications you are taking. Especially if those medications can increase bleeding risk. Your physician will require you to sign a consent form that gives them permission to perform the surgery. Your physician will likely advise you not to eat or drink for 12 or more hours before the surgery. They might also provide you with a sedative to help you relax.
Does A Laminectomy Require Anesthesia?
Most physicians recommend having the Laminectomy performed under general anesthesia, though some individuals can remain awake under spinal anesthesia.
How Is A Laminectomy Performed?
It starts with the physician or surgical technician starting an IV line. Once you are asleep or the spinal anesthesia takes effect a urinary drainage catheter may be inserted. An anesthesiologist will continuously watch your heart rate, blood pressure, and blood oxygen levels throughout the surgery.
Any hair on the skin around the incision site will need to be shaved away. You will be positioned either on your side or belly on the operating table. The surgeon will then make a careful incision over the selected vertebra and the surrounding muscles will be spread apart.
At that point your surgeon will remove the bony arch of the posterior part of the vertebra, known as a lamina. This will help to ease the pressure on the nerves in the area. If necessary the surgeon may also need to bone spurs or growths in the area that are placing pressure on the nerves.
In some Laminectomy cases a spinal fusion may need to be performed at the same time. This involves connecting 2 or more bones in your spine to help stabilize that part of the spinal column and prevent future complications.
Once the necessary tissues have been surgically altered, the incision site will be closed with stitches or perhaps surgical staples, and a sterile dressing will be applied.
Recovery After A Laminectomy
You may need to stay in the hospital for one to two days after a Laminectomy if you are having complications with other medical conditions. Though rehabilitation can start as early as the same evening after the surgery with some light walking. Your physician will develop a pain management strategy, as well as providing you with a general exercise plan to follow both in the hospital and after discharge.
Some individuals may need to see a physical therapist after a Laminectomy for several weeks or months to improve or restore mobility.
At Home Care After A Laminectomy
You will need to keep the surgical incision area dry and clean until the skin has completely knit back together and the stitches or staples are removed. Your physician will give you specific bathing instructions. You will need to take prescription pain medications as directed.
While discomfort and minor swelling are to be expected, there are a few potential complications that can occur after a Laminectomy. You should contact your physician if you are experiencing any of the following.
- Redness and swelling at the incision site
- Drainage at the incision site
- Increasing pain around the incision site
- Increasing numbness in your legs, or lower back
- Difficulty urinating
- Loss of bowel or bladder control
How Long Does It Take To Fully Recover After A Laminectomy?
Most patients are able to return to light activity such as working at an office desk work or perhaps some light housekeeping within one to two weeks. Though this timetable could be expanded out to two to four months if your Laminectomy also included a spinal fusion, or you have other underlying medical complications.
If you have been experiencing neck and/or back pain, a Laminectomy is not likely the first step in the treatment process. Your physician might recommend other treatment methods first. This could include things like physical therapy, changes in exercises and activity, the use of mild prescription pain medications, or targeted steroid injections.
If these treatment plans fail to improve your overall discomfort and quality of life, then a Laminectomy might be something to consider. Though like any surgical procedure, it comes with risks and the recovery time can take weeks or perhaps even a few months. Especially if a spinal fusion was included in the surgical process.