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What is a Laminectomy?

What is a laminectomy

Laminectomy is a kind of surgical treatment used by patients suffering from back pain. Laminectomy, also known as decompression surgery or rachiotomy, can be done:

  • to relieve pressure on spinal nerves; 
  • treat a disc problem; 
  • or remove a tumor from the spine. 

One of the most common causes of laminectomy is a herniated disc. The disc may shift or become damaged due to injury or wear.

 

The method of laminectomy consists of removing the arch of the vertebra. 

  1. As a result, the nerve root is released (decompression occurs), the squeezing of which leads to pain. The cause of such pain is the narrowing of the spinal canal, resulting in compression of the nerve roots. 
  2. Pain in the legs, weakness in the joints, and problems with the pelvic organs are often added to acute pain in the lumbar spine. 
  3. After a period of rehabilitation, the patient can return to a full life.

 

During surgery, there are significant risks, and, after, potential complications. However, surgery must be done if other treatments fail.

 

Rachiotomy is the name given to various types of surgical resection of the spine to relieve compression of the spinal cord. This type of surgery consists of two main parts: laminotomy and rachiotomy. The difference is that with laminotomy, part of the plate is removed, and with rachiotomy, the entire plate is removed.

Laminectomy preparation

Laminectomy Preparation

Laminectomy is preceded by a thorough examination and an individual approach to each patient. The survey begins with a conversation. The doctor listens to complaints and asks in detail about the symptoms that the patient observes.

 

The specialist examines and palpates the areas of the body in which painful sensations arise. The next stage of diagnostics before laminectomy includes examinations using special equipment.

 

  • Radiography. This completely painless research method allows you to see the entire bone structure of the spine, including its damage, and determine what exactly caused the compression of the nerve roots in the lumbar spine. However, radiography will not provide an opportunity to examine soft tissue. Therefore, the doctor may prescribe the passage of another study – MRI (magnetic resonance imaging).

 

  • The MRI method is based on nuclear magnetic resonance and allows you to see possible pathological changes in soft tissues to determine, for example, diseases such as a herniated disc, which also leads to compression of the nerve roots, and back pain.

 

  • Computed tomography (CT). This method also uses X-rays but with a layer-by-layer display of the slices. CT allows you to see what is not available with X-rays due to the overlap of tissues and organs.

 

  • Lumbar puncture. It is carried out according to the testimony of a doctor and is a collection of cerebrospinal fluid for analysis using a syringe with a thick needle.

Types of Laminectomy

Surgical Procedures and Types of Laminectomy

 

Surgical procedures for laminectomy

 

  Laminectomy is performed in one of the following ways:

  • Mini-invasive discectomy (minidiscectomy) is a minimally invasive surgery to remove osteophytes or herniated discs that put pressure on the spinal cord. The operation is carried out in a modern operating room under a microsurgical microscope.
  • Decompression. This surgery is carried out in two stages under the control of an X-ray machine. First, the surgeon makes a small incision in the place where the nerve root was squeezed and removes part of its arch, having gained access to the affected vertebra. This manipulation is carried out to gain access to the spinal canal. After that, the formations that put pressure on the spinal cord are removed.

 

Types of surgeries with laminectomy

It is divided into four types: cervical, thoracic, lumbar, and sacral, depending on the situation in which the operation is performed.

 

1. Thoracic laminectomy

It is performed in the upper and middle lower back. Removing the tumor or reducing the compression of the spinal cord is the most common reason for this procedure.

Some tumors can form inside the spinal cord – for example, ependymomas, neural sheath tumors, meningiomas, hemangioblastomas, and astrocytomas. The surgeon must perform a breast laminectomy to gain access to the tumor and remove it.

 

2. Laminectomy of the cervix

This procedure removes the bony lining of the spinal cord and other soft tissues that are compressing the spine. This relieves the compression of the nerves behind the neck and spinal canal:

  • the procedure can last from one to three hours;
  • only used when non-invasive methods do not help;
  • if rest, pain relievers, physical therapy, and an epidural injection do not relieve pain, a cervical laminectomy is performed.

Sometimes the pain is accompanied by: 

  • weakness;
  • numbness in the limbs;
  • noise;
  • difficulty walking;
  • loss of bladder and bowel control.

In these cases, a cervical laminectomy is necessary.

 

3. Sacral laminectomy

It is the removal of the dorsal plate between the pelvis and the femur (sacral spine). This surgery relieves compression on the spinal nerves.

 

4. Lumbar laminectomy

It is often performed to relieve the sequelae of spinal stenosis. It can be caused by:

  • Tumors in the spine
  • Spinal stenosis. During the operation, the compression of the spinal cord in the thoracolumbar region is reduced
  • Congenital or congenital defects such as abnormal growth of the spine
  • Shrinking of intervertebral discs and swelling of bones and ligaments that occur with age
  • Shock injury
  • Achondroplasia, which is a type of dwarfism
  • Herniated disc
  • Paget’s disease, a condition in which bones do not grow properly
  • Spinal osteoarthritis, which is more common in older people.

Laminectomy process

Process, Risks, and Recovery of Laminectomy

 

Laminectomy process

Laminectomy is performed with general anesthesia and lasts from one to three hours. During the operation, not only the vertebral arches are cut off, but also the parts of the intervertebral disc located under the nerve root. Sometimes the operation can take place without damaging the bone structures. It is enough to make a hole in the yellow ligament of the spine to “release” the nerve root.

  1. During the laminectomy, the patient lies on their stomach or side. 
  2. The surgeon cuts the skin (3-4 cm) above the place where the squeezed root is located and gains access to the back wall of the spine. 
  3. It is important to determine which vertebra needs treatment. Therefore, during the operation, the doctor makes contrast radiography. 
  4. When the “diseased” vertebra is found, the surgeon cuts off parts of its arch – and the spinal canal is open for manipulation. 
  5. Often during the operation, the surgeon not only cuts off the vertebral arches, freeing the nerve root but also removes pathological formations that the patient has: disc herniation, bone spurs, etc.

Then the doctor sutures the dissected tissue in layers. The final stage of laminectomy is the stabilization of the spine. Damage to the joints connecting the vertebrae can injure the structure of the spine. It is possible to restore it with the help of implants.

 

Laminectomy risks

Spine surgery can have certain risks:

  • Unsuccessful surgery, which can lead to continued pain after surgery
  • Infection at the site of the surgery or in the bones of the vertebrae
  • Cerebrospinal fluid leaks due to rupture of the membrane surrounding the spinal canal
  • Spinal nerve damage
  • Back pain, especially after fusion.

Some risks threaten the patient in all operations; these include blood clots in the legs and pulmonary embolism, breathing problems, infection, blood loss, heart attack, stroke, and drug reactions.

 

Causes of post-laminectomy syndrome

Determining the causes of post-laminectomy syndrome is difficult to find out. But the formation of scar tissue after surgery can cause compression of the nerve roots and may explain the chronic pain that patients with post-laminectomy syndrome experience.

 

There are several other acceptable explanations for post-laminectomy syndrome, including:

  • incomplete removal of the vertebral arch;
  • inflammation in structures adjacent to the spinal cord;
  • surgical intervention on the incorrect spinal motion segment.

 

Other reasons that can affect the outcome of surgical treatment, include mental health problems of the patient.

 

Laminectomy recovering

This time depends on the scope of the operation and the patient’s condition. 

  1. If the laminectomy is minor, the patient will usually be able to do light housework and non-flexion work after a few days or a few weeks. 
  2. But if this operation is accompanied by a merge, the recovery time is longer; this can take anywhere from two to four months.

As soon as the doctor deems it appropriate, he will prescribe physical therapy exercises to accelerate recovery. In any case, you cannot be sure of your complete recovery until six weeks later.

 

 

FAQs

  • What is the most common reason for laminectomy?

One of the most common causes of laminectomy is a herniated disc. The disc may shift or become damaged due to injury or wear.

  • What is the name of back pain surgery?

Laminectomy refers to decompression surgery on the spine, which has a wide range of indications, including spinal cord injuries. It allows you to eliminate the pressure of other anatomical structures on the spinal cord and nerve endings by resecting the arches of the vertebrae in the affected area, their spinous processes, intervertebral discs, and the yellow ligament.

  • What drugs should be used for a laminectomy?

A course of physiotherapeutic treatment and a number of drugs, including:

    • antibiotics – prevent the development of infectious and inflammatory complications;
    • drugs from the NSAID group – relieve pain and help eliminate the inflammatory process;
    • anti-thrombotic drugs – reduce the risk of blood clots; calcium preparations – help to strengthen bone tissue.
  • What are the different techniques for performing laminectomy?
  1. Hemilaminectomy – the operation consists in resecting one or both arches of only one vertebra while its spinous processes are preserved.
  2. Interlaminar laminectomy – surgical intervention involves partial resection of the ligamentum flavum, the arch of the affected vertebra, as well as the arches of the vertebral bodies belonging to it.
  3. Total laminectomy – the essence of the operation is to remove the vertebral arch together with the spinous process.
  4. Osteoplastic laminectomy is a radical operation that implies further closure of the formed defect with a bone graft taken from a patient, an allograft (obtained from a donor), or artificial materials.

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Daneisha Johnson
Daneisha Johnson
22:20 19 May 22
Dr. Askari was very kind and explained everything so I could understand. The other staff were nice as well. I would... have gave 5 stars but I was a little taken aback when I checked in and had to pay 600.00 upfront. I think that should have been discussed in a appointment confirmation call or email just so I could have been prepared.read more
Jean Cooper
Jean Cooper
16:54 29 Apr 22
I love the office staff they are friendly and very helpful. Dr. JODIE is very caring and understanding to your needs... and wants to help you. I will go back. would recommend Dr. Dr. Jodie to other Patients in a heart beat. The team works well together.read more
Linda M
Linda M
19:40 02 Apr 22
I was obviously stressed, needing to see a neurologist. The staff was so patient and Dr. Ansari was so kind. At one... point he told me to relax, we have time, when I was relaying my history of my condition. That helped ease my stress. I have seen 3 other neurologists and he was the only one who performed any assessment tests on my cognitive and physical skills. At one point I couldn't complete two assessments and got upset and cried. I was told, it's OK. That's why you're here. I was truly impressed, and super pleased with the whole experience!read more
Leslie Durham
Leslie Durham
15:05 01 Apr 22
I've been coming here for about 5 years. The staff are ALWAYS friendly and knowledgeable. The Doctors are the absolute... best!! Jodie Moore is always in such a great mood which is a plus when you are already stressed. Highly recommendedread more
Monica Del Bosque
Monica Del Bosque
14:13 25 Mar 22
Since my first post my thoughts have changed here. It's unfortunate. My doctor and PA were great, but the office staff... is horrible. They never call you back when they say they will, they misinform you, they cause you too much stress wondering what's going on, they don't keep you posted. They never answer the phone. At this point I've left four messages in the last week, and I have sent three messages. Twice from their portal and one direct email. No response. My appointment is on Monday morning at 8:30am, no confirmation on my insurance and what's going on. What the heck is going on, this is ridiculous!I've given up... the stress her office staff has put me through is just not worth it. You can do so much better, please clean house, either change out your office staff, or find a way for them to be more efficient please. You have to do something. This is not how you want to run your practice. It leaves a very bad impression on your business.read more
Ron Buckholz
Ron Buckholz
23:32 23 Mar 22
I was actually pleasantly surprised with this visit! It took me a long time to get the appointment scheduled because no... one answers your phones EVER! After a month, I finally got in, and your staff was warm, friendly, and I was totally impressed! I feel like you will take care of my needs!read more
Steve Nabavi
Steve Nabavi
16:28 16 Mar 22
It was a nice visit. Happy staff doing all they can do to comfort the patients in a very calming environment. You ask... me they are earned a big gold star on the fridge. My only complaint they didn't give me any cookies.read more
Katie Lewis
Katie Lewis
16:10 10 Feb 22
Had very positive appointments with Jodie and Dr. Sheth for my migraine care. Jodie was so fast with the injections and... has so much valuable info. I started to feel light headed during checkout and the staff was SO helpful—giving me a chair, water, and taking me into a private room until I felt better. Highly recommend this practice for migraine patients, they know what they’re doing!!read more
Joshua Martinez
Joshua Martinez
16:02 10 Dec 21
I was scheduled to be checked and just want to say that the staff was fantastic. They were kind and helpful. I was... asked many questions related to what was going on and not once did I feel as though I was being brushed off. The front desk staff was especially great in assisting me. I'm scheduled to go back for a mri and am glad that I'll be going there.read more
Isabel Ivy
Isabel Ivy
21:42 03 Nov 21
I had such a good experience with Lone Star Neurology, Brent my MRI Tech was so awesome and made sure I was very... comfortable during the appointment. He gave me ear plugs, a pillow, leg support and blanket, easiest MRI ever lol 🤣 My 72 hour EEG nurse Amanda was also so awesome. She made sure I was take care of over the 3 days and took her time with the electrodes to make sure it was comfortable for me! Paige was also a huge help in answering all my questions when it came to my test results, and letting me know her honest opinions about how I should go forth with my treatment.read more
Leslie Luce
Leslie Luce
17:37 20 Oct 21
The professionalism and want to help attitude of this office was present from the moment I contacted them. The follow... up and follow through as well as their willingness to find a way to schedule my dad was above and beyond. We visited two offices in the same day with the same experience. I am appreciative of this—we spend a lot of time with doctors and this was top notch start to finish.read more
robert Parker
robert Parker
16:38 16 Apr 21
I love going to this office. The staff is friendly and helpful. The doctor is great. I am getting the best... neurological tests and treatment I have ever had. The only reason I did not give them a 5 star rating is because it is impossible to reach a live person at the office to reschedule appointments. Every time I have tried to get through to the office it says all people are busy and I am sent to a voicemail. If they could get their phone answering fixed, I would give them a strong 5 stars.read more
MaryAnn Hornbaker
MaryAnn Hornbaker
00:26 25 Feb 21
Dr. Harney is an excellent Dr. I found him friendly , personable and thorough. I evidently am an unusual case. ... Therefore he spent a Hugh amount of time educating me. He even gave me literature to further explain my condition and how to follow up. This is something you rarely get from your doctors. So I am more than please with my doctor and his staff.read more
Roger Arguello
Roger Arguello
03:05 29 Jan 21
Always courteous, professional. The staff is very friendly and always work with you to find the best appointment time.... The care team has been great. Always taking the time to listen to your concerns and to find the best treatment.read more
Margaret Rowland
Margaret Rowland
01:12 27 Jan 21
I have been a patient at Lone Star Neurology for several years. Now both my adult daughters also are patients there. I... love Jodie. She is always so prompt whether it is a teleamed call are a visit in the office. She takes the time to explain everything to me and answers all my questions. I am so blessed to have Jodie as my doctor.read more
Susan Miller
Susan Miller
03:01 13 Jan 21
My husband had an accident 5 years ago and Lone Star Neurology has been such a blessing to us with my husbands care.... Jodie Moore is his provider and she is amazing! Jodie is very knowledgeable, caring, and thorough. She takes her time with you, making sure your needs are met and she is happy to answer any questions you may have. Lone Star Neurology’s patients are very lucky to have Jodie providing their care. Thank you Lone Star Neurology and especially Jodie for everything you have done for us. Jodie, you are the best!read more
Windalyn C
Windalyn C
01:32 09 Jan 21
Jodie is wonderful. She is very caring and knowledgeable. I have been to over a dozen neurologists, and none were able... to help me as much as they have here. Thanks!read more
Katie Kordel
Katie Kordel
00:40 09 Jan 21
Jodi Moore, nurse practitioner, is amazing. I have suffered from frequent, debilitating headaches for almost 20 years.... She has provided the best proactive and responsive care I have ever received. My quality of life has been greatly improved by her caring approach and tenacity in finding solutions.read more
Ellie Natsis
Ellie Natsis
15:41 07 Jan 21
I have had the best experience at this neurologist's office! For over a year I have been receiving iv treatments here... each month and my nurse, Bobbie is beyond wonderful!! She's so attentive, knowledgeable, caring, and detail oriented. She makes an otherwise uncomfortable experience much more pleasant and definitely puts me at ease! She also helps me with my insurance,ordering this specialty medication and dealing with the ordering process which is no easy feat.Needless to say, she goes above a beyond in every way and I'm so grateful to this office and to Bobbie for all they do for me!read more
Matt Morris
Matt Morris
15:39 07 Jan 21
Let me start by saying that I have been coming here for years. Due to my autoimmune disease, I am in this office... once every three weeks for multiple hours at a time. The office is very clean and the staff very friendly. My only complaint would be there communication via phone. They aren't the best at responding if you leave a voicemail and expect a call back. I understand that this is prob just due to the sheer number of alls they receive daily. What I can say I like the best about the office are the people. Bobby who handles my infusions is great. I never have any issues with her setting up my infusions. She is very quick to reply to messages sent via text and if she were to leave then my whole opinion of the office may change. I also enjoy people like Matt, Lauren, and Jodi. I appreciate all that they do for me and without this team I'm not sure I would be as happy as I am to visit the office as frequently as I have to. Please ensure that these folks are recognized as they are what makes my visit to this office so tolerable :).read more
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