Spinal surgery
A common spinal surgery is called a laminectomy.
A laminectomy is a surgical incision (cut) into the vertebra (backbone) to get access to the structures associated with the spinal cord. It is usually performed in the cervical and lumbar regions, and less often in the thoracic region. The operation is performed to relieve pressure on the spinal cord or spinal nerves, to remove herniated intervertebral discs, or to remove tumours.
Reasons for a laminectomy
One of the most common reasons for a laminectomy in the lumbar region is a prolapsed or herniated intervertebral disc. If the herniated disc is in this region, it can cause sciatic nerve pressure with pain radiating down the leg, as well as weakening of the muscles in the leg, and some loss of sensation in the leg and foot. It may also be difficult to raise your leg when it is held in a straight position due to pain.
Another common reason for a laminectomy is degeneration or arthritis of the spine. This leads to narrowing of the pathways that nerves travel through (vertebral canal or foraminae) and can also cause sciatic nerve pressure. It may be difficult to walk due to aching or burning in the legs after short distances (claudication).
Diagnosis of spinal problems
Tests are usually performed before surgery to aid diagnosis. These tests may include:
- plain spinal x-rays
- myelogram (rarely performed)
- computerised tomography (CT) scan
- magnetic resonance imaging (MRI) scan.
Before
Laminectomy procedure - What to expect
Your surgeon should explain the nature of your operation, the reasons for it, the outcome and the possible risks involved. They should be able to tell you the approximate length of stay in hospital that will be required and the number of weeks you will need to recuperate before returning to work. You may initially require inpatient rehabilitation for a short period of time.
Your anaesthetist will visit you to see how suitable you are for surgery. Laboratory tests, including blood and urine samples, are taken before the operation.
You will have ‘nil by mouth’ (nothing to eat) for a number of hours prior to surgery. A pre-medication injection is usually given to make you drowsy and dry up some internal secretions.
A laminectomy is usually performed under general anaesthetic. The position you are placed in on the operating table depends on the position of your narrowing or herniated disc.
After
What to expect after a laminectomy
After the operation, you can expect:
- Routine post-operative observations will be taken and charted, including temperature and blood pressure.
- Your wound is checked for redness, swelling and signs of infection.
- Muscle spasms are not uncommon following laminectomy. Pain relief and antispasmodic medication are given regularly.
- Your ability to pass urine is recorded, as sometimes this may be affected immediately following surgery.
- You may have a drain-tube placed during surgery, which is taken out after one or two days.
- You may have intravenous fluids for a few days, which may include an antibiotic.
- Initially, you will be shown how to roll over in bed. You are taught the proper method of rolling your body in order to maintain proper body alignment. This is most important for the first 48 hours or so.
- You are helped to get out of bed usually within 24 hours. The physiotherapist will give you specific instructions on how to get out of bed properly to avoid stress and strain on your wound site. You may feel light-headed when you first get out of bed.
- You are encouraged to walk, stand and sit for short periods. You are taught how to prevent twisting, flexing or hyper-extending your back while moving around.
- You may be referred for inpatient or outpatient rehabilitation.
Where to get help
- Your doctor
- Neurosurgeon