Hemilaminectomy Surgery (partial laminectomy), Decompression surgery, Laminectomy Surgery:
This surgery is done to remove the bony arches from one or more vertebrae in your back. As time passes, wear and tear on your spinal column causes the nerves in your spine to become compressed by the bones. By removing these bones, compression and pain are usually greatly reduced.
A spinal column is, in simple terms, a series of bones that are held together by ligaments and muscles. There is a soft material between each one of these bone disks, and it helps keep the contents of the spine protected.
If these disks or bones become damaged or worn, then the nerves that go through the spine will not have enough space to work correctly. Compression of these nerves will cause moderate to severe pain in various areas of your body, and the area will depend on the nerve that is compressed.
A laminectomy or hemilaminectomy procedure may be required when this occurs. The surgeon will actually remove part of the bones in order to alleviate nerve during the surgery.
Length of decompression surgery: Approximately 90 minutes.
Length of Hospital Stay: You can expect to remain in the hospital approximately 2-3 nights.
Recovery time before going home: Recovery time is estimated to be two weeks. Business or First Class seating on the flight home highly recommended.
How do I know whether I need a spinal fusion?
Details of laminectomy surgery:
The procedure or technique that the surgeon will use will be discussed with you. At the start of the surgery, the surgeon will make an incision down the place in the spine where the compression is taking place. Using precision instruments, the surgeon will move the muscle to expose the lamina, and the spinal surgeon will then proceed to eliminate the herniated disk compression.
Once the nerves are released from the compression, tissues will be reconnected by the surgeon, and he will then proceed to close the incision.
What happens after surgery?
You will be awakened, and then you may notice any or all of the following:
Sometimes a Foley catheter is used during spinal decompression surgery. This is a tube that is placed into your bladder to drain urine into a plastic bag. Draining your urine is an important step in order to avoid unnecessary complications.
If you want to avoid complications after surgery, you will need to do deep breathing exercises. You will be asked to take 10 deep very deep breaths every hour to accomplish this, and your physician could even prescribe a spirometer to assist in your deep breathing exercises.
Prevention of deep venous thrombosis or DVT after surgery is essential since it could be a serious complication. You will be lying down for lengthy periods of time, and the blood in your legs could become static, which would then tend to form potentially dangerous clots. and will have a tendency to form clots.
As a DVT prevention method, medications, compression stockings, and perhaps pneumatic boots could be prescribed by your surgeon and/or physician. When you are finally recovering at home, there will be special exercises that you need to perform which will have been prescribed by your doctor.
Just as each person is different, each decompression surgery or laminectomy is different. There could be medications prescribed while you are at the hospital and recovering from your surgery, and the nursing staff should explain the benefits, risks and alternatives to the following medication:
When used the way they are prescribed, antibiotics are great for infection prevention; be sure to follow your physicians instructions and take the entire antibiotic cycle as prescribed.
Anti-clotting medication could be prescribed to reduce the risk of DVT.
- Anti-nausea medication might also be prescribed if you become nauseous due to the use of anesthesia during the procedure. Anti-nausea medication will also help you feel better as you recover from your surgery.
- Pain medication will likely be used as part of an overall pain management plan. Your pain management plan might include a catheter in your spine, or perhaps a self-controlled pain medication pump. Although you will have undergone major surgery, the pain you feel should be manageable and perhaps even minimal.
- If you need to ease your bowel movements, a stool softener could be prescribed.
- In order to allow you to sleep well during the first few nights after surgery, a sleep inducer could be prescribed. It is a very well-documented fact that a good night’s rest and deep sleep can help speed up recovery.
- It is a must for you to start physical therapy as soon as possible after surgery. You will have a physical therapist, and you will be encouraged to increment from passive to active weight bearing exercises in a progressive manner. The idea is to avoid muscle atrophy and the muscle wasting away.
Results of laminectomy or hemilaminectomy:
Decompression surgery has proven itself to be very successful. You can expect to return to your normal activities without any extra assistance. However, the pain sometimes returns after decompression surgery in some cases. On the other hand, the surgery relieves stiffness and pain in most cases, and it allows most patients to return to a high quality of life.
Alternatives to Treatment and Risks:
There are risks which are inherent in every surgical procedure, and a laminectomy is no exception. The risks involved with this type of surgery are minimal, but you should still be aware of them. In addition to risks that are inherent in the surgical procedure, each individual will have his or her own set of risks which need to be fully discussed with the surgeon and/or personal physician before the surgery.
There are known risks that are associated with anesthesia. These are mainly related to the patient having an allergic reaction to the medications used in anesthesia. Breathing difficulties have also been known to occur, but your surgical team is experienced and trained in dealing with any and all possible adverse reactions.
Among the known risks related to the surgical procedure are: blood loss, bone, nerve, blood vessel, and/or ligament damage. You could also experience complications such as infection, blood clots, or even new pain.
Nerves may be damaged may during the surgery, but the surgical team has lots of experience with this type of surgery and the risk of nerve damage is minimal. Spine instability is another complication that could arise from this type of procedure and it could lead to a spinal fusion.
Complications could lead to a second surgery so that the problem can be corrected, and you will have an expert team with you every step of the way, not only to lessen the chance of complications, but also to deal with them in they even they should arise. If there is a complication, your surgical team will instruct you with regards to the treatment options available.
Your Surgeon must be contacted if:
You have a fever.
Your wound smells bad, oozes or feels hot.
The problems get worse after having the surgery.
You feel more pain in your legs or you have a loss of sensation.
During urination, you feel a burning sensation or a lot of pain.