Everything about Laminectomy surgery for back pain. Don't be afraid, let's talk!

Do you also have unbearable pain in your back, neck, or legs? Do you sometimes feel numb and lifeless with this pain? Then your doctor may have told you about a surgery called Laminectomy. The name sounds a little scary. But don't worry. Let's talk about this simply, in a way that everyone can understand.

What is a laminectomy?

Simply put, a laminectomy is a type of spinal surgery. Our spine is made up of small bones stacked on top of each other. These are called vertebrae. Each vertebra has a small arch-like part at the back called the lamina. In this surgery, the surgeon removes part or all of the lamina.

Why do we do that? Doing so increases the space available for our spinal cord and nerves inside the spine. The compressed nerves are released. Then, we get great relief from unbearable pain and numbness.

Why do you need a Laminectomy?

The main reason for this is the narrowing of the spinal canal. In medical terms, we call this spinal stenosis . As we age, or for other reasons, the path through which the spinal cord passes can become narrow. Then the nerves inside it start to get compressed. This can cause various symptoms.

Laminectomy surgery may be necessary for several other reasons besides spinal stenosis.

• Arthritis : Joint swelling and pain.
• Bone spurs: Bone spurs that grow outside of the spine can press on nerves.
• Herniated disc: A jelly-like piece of material between the vertebrae bulges out and presses on nerves.
• Degenerative Disk Disease : The cushion between the vertebrae of the spine wears down with age.
• Spinal tumors: Sometimes these tumors can form near nerves and cause pressure.
• Spinal Infections: Infectious conditions affecting the spine.

How do you prepare before surgery?

Before your surgery, your doctor will give you detailed instructions on how to prepare. These may include:

• Get new imaging tests: Your doctor may order X-rays or MRI scans to get a clearer picture of your spine.
• Stop taking certain medications: Some medications you take (including vitamins and supplements ) can affect the surgery and the healing process. So only take the medications your doctor tells you to.
• Avoid smoking: If you smoke, you are more likely to have complications before and after surgery. If you are having difficulty quitting, talk to your doctor about it.
• Plan to rest: You will not be able to do heavy work for a while after the operation. So, pack your household items in advance. Get as many household chores done as possible.
• Let family and friends know: It's a great strength to have someone to support you during your recovery.
• Do not eat or drink anything after midnight the night before the surgery: This is very important. Follow the doctor's instructions exactly.

What happens during the surgery?

This surgery is performed under general anesthesia . This means you won't feel anything, you'll be completely asleep. The anesthesiologist and his team will carefully monitor your heart rate and breathing throughout the surgery.

Here are the steps of the surgery:

1. Anesthesia: You will be put completely asleep by placing a mask on your face or by injecting medicine into a vein in your arm.

2. Positioning: You will be turned face down to make it easier to perform the back surgery.

3. Skin incision: A small incision is made on the skin of the back above the painful area.

4. Lamina removal: The doctor will pull the muscles aside to expose the spinal cord. Then, any bone fragments, bone spurs, or ligaments that are pressing on the nerves are cut and removed. This is called decompression .

5. Other surgeries if needed: Sometimes, other surgeries may be performed at the same time as this surgery. For example, spinal fusion surgery, which joins several vertebrae together to stabilize the spine, or diskectomy surgery, which removes a herniated disk.

This surgery usually takes about 1-3 hours, but the time can vary depending on the complexity of your condition. Finally, the incision is closed with stitches or staples. Then you are turned back onto your side and the anesthesia is stopped.

After surgery and after returning home

After the surgery, you will be taken to a post-op unit and carefully monitored. When you wake up, you will feel a little groggy for a while. It is normal to feel some back pain. You will be given painkillers for this. You will usually have to stay in the hospital for a day or two.

It is important to get out of bed and start walking as soon as possible. This can help prevent blood clots from forming. Your doctor will often recommend physical therapy.

Take care of these things after you get home:

• Do not drive: Avoid driving for 1-2 weeks. Your doctor will tell you exactly what to do.
• Avoid heavy lifting: Avoid bending or lifting for a few weeks.
• Keep the stitches clean and dry: Since they are on your back, have someone help you clean the stitches. Ask your doctor for instructions on how to bathe.
• Don't travel long distances: Air travel and long car rides can cause blood clots in the legs. If you must travel, get up and walk around every hour.

You can usually return to normal activities in 4-6 weeks. However, if you have also had a spinal fusion, it can take about 2-4 months to heal. It is very important to be patient.

Risks and complications of surgery

Like any surgery, Laminectomy surgery has some risks.

• Bleeding
• Blood clots
• Infection at the surgical site
• Nerve damage
• Spinal fluid leak (Cerebrospinal Fluid - CSF)
• Weakened spine

What is Post-Laminectomy Syndrome?

Sometimes, very rarely, the pain does not go away completely after this surgery as expected. Sometimes the pain may increase and new symptoms may appear. This is what we call Post-Laminectomy Syndrome (or Failed Back Surgery Syndrome).

If this happens, there are various treatments available. So if the pain persists after surgery or if you experience any other unusual symptoms, see your doctor again as soon as possible.