Laminectomy

Laminectomy, also known as decompression surgery, is a procedure which involves the removal of the lamina. The lamina is a portion of the vertebral bone, which forms the posterior wall of the spinal cord and encloses it. A laminectomy is usually performed to treat spinal stenosis, a condition which causes a narrowing of the spinal canal or spinal openings which causes pressure on the spinal cord and spinal nerves. Spinal stenosis can be of two types, depending on its location on the spine. They are:-

  • Lumbar spinal stenosis- in this type of stenosis, the narrowing occurs in the part of the spine in the lower back.
  • Cervical spinal stenosis- refers to the narrowing of the spinal cord in the neck. It has adverse effects and is therefore, comparatively a little more serious.
Know More About Surgery

A laminectomy is needed if the patient is diagnosed with a spinal stenosis. Spinal stenosis presents with the following symptoms :-

  • Numbness, Pain and cramping in the back
  • Pain in legs, thighs, neck, shoulders or arms
  • Problems related to bowel movements or bladder control
  • Pain that is not continuous, and may occur while performing physical activities like walking, bending etc.
  • Occurrence of sciatica
  • Weakness in the limbs
  • Problems pertaining to balance

Spinal stenosis can be diagnosed in the following manner

  • A physical exam by the doctor can help in the diagnoses of spinal stenosis. The doctor may ask the patient to perform simple activities like walking, standing, bending forwards and backward and then diagnose on the basis of the location and the intensity of the pain.
  • X-ray – can show changes in the shape of the vertebrae
  • Electromyography (EMG) – an EMG helps in determining the health of the muscle and the nerves and soft tissue causes of stenosis
  • CT scan – a CT scan involves injected a dye in the spinal sack which can help determine with clarity, both, bone related causes and soft tissue causes like disc bulges and herniations and ligament hypertrophy.
  • MRI scan- MRI scans use radio waves to take pictures of the spine and can help in identifying any changes like damage to the discs and abnormalities in the spinal cord like tumors.

For the treatment, general anesthesia is administered to the patient, and therefore the patient is unconscious and would feel no pain. Mechanical ventilation is used during the surgery to aid breathing. Vital signs like heart rate are continuously monitored during the surgery. The surgeon makes an incision on the back over the area that requires surgery. He will then move the muscles and tissue away from the spine in order to get a better view of the spine. The surgeon will then remove the lamina or any bone spurs or ligament that is compressing the nerves. How much of the lamina is removed depends upon the condition of the patient. The incision is then closed using stitches.

As with any major surgery, laminectomy also has a few possible risks and complications as listed below:-

  • Excessive bleeding
  • Risk of infection
  • Heart attack or stroke
  • Risk of damaging the spinal cord and spinal nerves which could lead to serious damage
  • A leak of the cerebrospinal fluid
  • Blood clots which could travel to the lungs resulting in a pulmonary embolism
  • Reaction to the medications used in surgery

The patient might have to continue pain medications post the surgery. Strenuous activities such as walking or standing for too long, bending, lifting heavy weights etc. should be avoided post surgery for at least two to three months.

Laminectomy from one of the best multi-speciality hospital: Manipal Hospital Dhakuria, Gariahat, Kolkata

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