16 Feb Chronic Back Pain and the Laminectomy Surgery
Chronic back pain can interfere with normal daily activities for many patients. A surgery used to relieve back pain is the laminectomy, which involves removal of a small portion of the vertebral bone (lamina). This eases compression of the spinal cord and nerves, and is a surgery done only after the patient fails on conservative measures (physical therapy, medications, and epidural steroid injections).
What conditions are treated using laminectomy surgery?
The laminectomy surgery is used to treat compression of spinal cord and/or nerve roots caused by:
- Herniated disc
- Spinal stenosis
- Spine injury
- Spinal tumors
- Chronic low back pain
- Severe degenerative disc disease
What causes chronic low back pain and radiculopathy?
Nerve irritation can occur when a disc is damaged or displaced, or when the spinal bones protrude into the spinal canal. When something presses on spinal nerves, it causes back pain and shooting pain into the buttocks and leg. Other symptoms include leg weakness and numbness, which is related to pressure on the nerves that supply the extremity.
How do I prepare for the laminectomy surgery?
Your healthcare provider will review the risks and benefits of the laminectomy, and have you sign a consent form. The doctor first orders some presurgical tests (blood work, x-rays, and EKG) to assure you are fit for the surgery. In addition, you should tell the doctor is you are taking blood thinning medicine or are allergic to latex or any surgical tools or solutions.
Because general anesthesia is used, you need to fast for 8 hours before the procedure. In addition, most patients meet with the physical therapist before surgery to go over rehabilitation plans.
What happens during the laminectomy surgery?
After you arrive at the surgical center, a nurse has you change into a procedure gown and places an IV catheter in your arm. You are moved to the procedure room and given general anesthesia. After being positioned face down on a specially padded procedure table, the doctor cleans the back using a surgical antiseptic solution. The skin and deeper tissues are numbed using a local anesthetic, which offers postoperative pain relief.
A small incision is made over the affected vertebra, and a small retractor is used to spread the muscles apart. The bony arch of the vertebra (lamina) is removed to relieve nerve pressure. This involves irrigating the area to remove disc fragments and debris. In addition, the doctor will remove any bony growths or spurs in the surgical region. Two or more vertebrae are fused together to stabilized the spine using special surgical instruments. After all surgical changes are made, the incision is closed using staples or sutures, and a dry sterile bandage is applied.
What happens after the laminectomy procedure?
Most patients are kept in the hospital overnight for observation. Immediately after the procedure, you are monitored for 75-90 minutes by a nurse in the recovery room. The back may be numb for a few hours, but as the anesthetic wears off, you will feel some pain and soreness. The nurse will administer pain medications to relieve this discomfort. The therapist begins working with you on getting in and out of bed, and gives you an exercise plan to improve flexibility and strength of the back. After going home, the therapist will meet with you several times a week to work on your recovery.
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