Imagine you’re at a summer BBQ and your friend Jake comes up to you and suddenly starts talking about his recent medical issues.
Now, Jake has had a long history of back pain and discomfort, so you’re more than familiar with him talking your ear off about his back issues.
But suddenly he starts throwing out some medical jargon that has your head spinning.
He uses the word…
What is a Laminectomy?
You stand there nodding like you know what he is talking about.
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But inside your thinking…
What is a laminectomy?
Do I need one?
And why would anyone need this specific medical procedure?
A laminectomy is a type of spinal surgery that results in removing part of or all of your vertebral bone.
This type of procedure is considered decompression surgery.
In a laminectomy, the surgeon first removes the bony spinous process, followed by the bony lamina.
After that, a thickened connective tissue made of collagen known as the ligamentum flavum is removed.
This process is then repeated at each affected vertebral level.
A laminectomy aims to remove or ease pressure on the spinal cord or the nerves surrounding the spine.
The pressure on the spinal cord or nerves could have been caused by injury, a herniated disk, narrowing of the spinal canal, or pathologies such as a tumor or mass.
Why would I need a laminectomy?
A laminectomy is not considered first-line treatment.
It is usually a last resort treatment used when other more conservative methods of medical treatment have failed, such as chiropractic care, physical therapy/occupational therapy, or spinal injections.
A laminectomy could be considered when lower back or neck pain is persistent, severe, and debilitating.
Suppose the pain in your spine is restricting or inhibiting your ability to move or perform your normal activities of daily living.
In that case, a laminectomy could be an option for you after all other more conservative treatment alternatives have been explored.
Another reason a laminectomy could be considered is if there are severe symptoms of nerve damage in the distal extremities, such as numbness or weakness in the arms or legs.
A loss of bladder and bowel control is also considered a severe symptom of nerve compression or spinal cord injury, indicating the need for a laminectomy if not corrected with other medical treatments first.
What are the risks involved with laminectomy?
A laminectomy is considered major surgery.
It is usually performed using general anesthesia; therefore, you are unconscious during the procedure.
As with any major surgery, there are risks to consider, such as bleeding, infection, blood clots, nerve injury, and spinal fluid leaking.
These potential risks are not meant to scare you but should be addressed by your medical care team so that you are fully prepared and informed.
Before agreeing to a laminectomy, you and your healthcare provider should schedule a consult and go over all of the following factors:
- What region of the spine will the laminectomy be performed on
- What are your other surgical or non-invasive treatment options?
- If you are allergic to any medications or materials used during the surgery
- Your healthcare provider should go through your complete medical history with you to address any underlying medical concerns or red flags.
- Review a complete history of current and past medications
- Talk about your recovery plan and if physical therapy is needed post-surgery
- Go through the laminectomy procedure/risks with you completely and thoroughly to know precisely what will happen during the procedure.
What is recovery from a laminectomy like?
After a laminectomy is performed, you will be monitored in the hospital for potential complications regarding the surgery or anesthesia.
In the recovery room, you will most likely be asked to perform basic movements such as moving your arms and legs to ensure no nerve damage was sustained during the surgery.
Every recovery process is different.
Some patients may be released the same day from the hospital, while others might endure a short-term hospital stay.
Medications to help control and manage pain may also be given during and after your hospital stay.
Depending on your job and its physical demands, you might be able to return to work in a few weeks.
If your job requires heavy lifting and labor, your doctor might ask you to return to work with light-duty restrictions; writing you limitations on lifting heavy objects, driving, and bending over.
After returning home, your doctor might also recommend physical therapy to help improve strength and flexibility post-surgery.
What will my pain be like after a laminectomy?
After a laminectomy, most patients will see an improvement in their symptoms.
Often reported is a decrease in pain that radiates down the legs or arms.
If you suffer from other underlying conditions such as aggressive or severe forms of arthritis, your reduction of symptoms could lessen as time progresses.
Overall, a laminectomy is not likely to improve pain in the back itself.
What are my other treatment options?
There are a few options to try before a laminectomy becomes your first option.
This is a conservative medical therapy often used to help improve pain and disability associated with back or neck pain before surgical options are explored.
Chiropractors can use a wide variety of methods to help decrease your pain and discomfort.
When seeking care from a chiropractor for pain associated with nerve compression or spinal cord compression, methods often used to help decompress the spine are the Cox Flexion Distraction Technique and Spinal Traction.
These two specific methods help to decrease the pressure or tension put on the spinal cord and nerves.
This is a conservative medical therapy that often utilizes exercise and movement-based protocols to help treat and manage back and neck pain.
The purpose of physical therapy is to teach the patient how to properly move their body through their activities of daily living by teaching the patient-specific flexibility exercises, strengthening exercises, and movement patterns.
These techniques help decrease the chance that a specific movement such as bending over to pick an object up will not hurt the patient if they have the correct knowledge of moving through the motion correctly.
This is a similar medical treatment to physical therapy.
The purpose of occupational therapy is to evaluate a patient’s living and working environment to see if any adaptive equipment or training is needed to help them live in an environment that helps their disability.
This type of medical treatment can include providing the patient with exercises to do at home or work, allowing the patient extra time at work or home with certain tasks, allowing the patient to use adaptive equipment at work or home to help with activities of daily living.
This is a more invasive treatment option after more conservative therapies such as the three listed above but before surgery becomes an option.
Spinal injections have been used for many years to treat various back pain symptoms such as sciatic pain, radiculopathy, radiculitis, nerve root compression pain, and disk herniation pain.
A spinal injection aims to decrease inflammation close to the site of pain, in turn decreasing the patient’s pain levels and disability levels.
All of the treatments above would be considered before a laminectomy is decided on or if the patient chooses to take a more conservative approach to treatment.
Each medical treatment listed above should be talked through with your healthcare provider to help you find the treatment and plan that works the best for you.