|
||||||
Laminectomy Surgery
Relevant information about Laminectomy Surgery.
Laminectomy, also called decompression, is a surgical procedure in which a portion of the bony arch, or lamina, on the dorsal surface of a vertebra from the spinal column is removed. The main goal of this procedure is to relieve the pain caused by Spinal Stenosis or herniated disk symptoms. In most cases, Laminectomy is an elective surgery rather than an emergency operation.
There are two problems that usually require a Laminectomy. The first one is known as Spinal Stenosis or narrowing. This is a condition that occurs within the spinal column when the spinal canal that contains the nerve roots and spinal cord becomes restricted. This narrowing, that can affect one or more areas of the spinal column, ends up squeezing the nerves and the spinal cord. The pressure caused, generates lower back and leg pain. Pain tends to occur after walking and relieves when the individual sits down or does an action that bends forward the spinal column, thus generating more space for the spinal cord and nerves from the spinal canal. Individuals with Arthritis or over the age of 50 tend to develop Spinal Stenosis, resulting from disease or age progression. Also, some individuals can have Congenital Stenosis, which happens when the person is born with a small spinal canal. However, some of the individuals who suffer from a type of Spinal Stenosis never develop symptoms. The causes of this are unknown. The second problem that is usually treated with a Laminectomy is a prolapsed or herniated intervertebral disc. This condition may happen when due to a big pressure, a spinal column disc bulges out from between two vertebrae, thus compressing the spinal canal. If the herniated disc is in the lumbar region, this will cause sharp and continuing back pain, a weakening of the muscles in the leg, and some loss of sensation in the leg and foot. In addition, it may also be difficult to raise the leg when it is held in a straight position. A herniated disc in the neck region will cause pain, numbness and weakness in the arm.
First of all, the patient is usually positioned lying on the side or stomach. The procedure begins by making a small straight incision over the damaged area. Next, a retractor is used to spread apart the muscles and fatty tissue overlying the spinal column. When the laminae have been reached, part of the bony arch is cut in order to expose the ligamentum flavum. This is a band of yellow tissue attached to the vertebra that helps to support the spinal column and closes in the spaces between the vertebral arches. Then, an opening is cut in the ligamentum flavum in order to reach the spinal canal and expose the compressed nerve. The cause of the compression will be visible at this point of the procedure. If the cause is Spinal Stenosis, then bone spurs, small disk fragments or soft tissue, may be removed in order to enlarge the spinal canal. If the problem is a herniated disk, the retractor will be used to move the compressed nerve aside. Next, in order to relieve pressure on the nerve, as much of the damaged disk as necessary will be removed. The space occupied by the disk will be eventually filled by new connective tissue. Finally, after the cause or causes of the pain have been removed, the incision is closed in layers using different types of sutures for the muscles, soft tissues, and skin.
After the surgery, most patients will remain in the hospital for one to three days. During this period the patient will be given fluids and antibiotic medications intravenously to prevent infection. Medications for pain will be given every three to four hours, or through a device known as a PCA which means patient controlled anesthesia. This device is a small pump that delivers a dose of medication into the veins when the patient pushes a button. After hospital stay pain medication will be continue to be taken for 2 to 4 weeks. Patient must avoid sitting or standing in the same position for a long time during the post-surgery process.
During this type of procedure nerve damage can happen due to the proximity of the spinal canal. This usually occurs when a surgical instrument damages one of the nerves from the zone. Consequence of this is muscle weakness and loss of sensation to the areas supplied by the damaged nerve. However this complication is rare.
The surgery prevents the zone treated from deterioration, and in most cases eliminates the pain and numbness symptoms.
Sometimes pain symptoms are not totally relieved by the operation. Also, Laminectomy doesn’t prevent further spinal column problems.
|
?
