Laminectomy is a neurosurgical operation on the spine to eliminate compression of the spinal cord and spinal nerve endings, provoked by various pathologies and injuries. Decompression is achieved by resection of the vertebral arches, spinous processes, intervertebral joints, and yellow ligament, resulting in reduced pressure on sensitive spinal structures. As a result, the nervous transport transmission is normalized, and pain and discomfort stop.
Laminectomy can be performed as an independent procedure, or used in combination with other surgical interventions on the spine. For example, in addition to its main purpose, this type of surgery is often necessary to create access for interventions on the spinal cord, such as the removal of tumors or foreign bodies. In some situations, surgical tactics are involved in the removal of an intervertebral hernia in order to provide more convenient access to it. Sometimes they turn to it to correct curvatures and deformities of the spine, for example, with pathological kyphosis.
Types of Laminectomy
Spinal laminectomy can be performed according to one of several technical options. The principle of intervention is chosen taking into account the state of the spinal system, the type, and the specificity of the disease. So, in modern neurosurgery, vertebrology, and orthopedics, such leading decompressive techniques are used as:
- Hemilaminectomy - a procedure to remove the arch of only the 1st vertebra on one side or its arches simultaneously on both sides with the preservation of the spinous processes;
- Interlaminar laminectomy - a method in which the yellow ligament is partially resected, as well as the arch of not only the affected vertebra but also the arches of the vertebral bodies adjacent to it;
- Total surgery - a technique in which the vertebral arch is excised along with the spinous process;
- Osteoplastic laminectomy is a big laminectomy intervention with subsequent closure of defects with autologous bone material, allograft or artificial tissue.
Before performing a laminectomy (the process is well shown in the video), skeletonization is necessary. The skeletonization of the vertebrae is the exposure of the main parts to be resected: arches, spinous processes, and facets. This requires the highest professionalism, richest experience, and ultimate accuracy of the actions performed by the surgeon.
Even one small mistake made during manipulations on the spine can end very badly for the patient, lead to irreversible damage to the nervous tissue and substance of the spinal cord, chronic pain, paralysis, etc. So choose your doctor very carefully.
Who Needs Laminectomy?
The surgery may be appropriate in the following pathological conditions that cause compression of the spinal cord and nerve roots:
- intervertebral hernia of large size;
- intraarticular and vertebral osteophytes,
- tumors of the spine (bone, spinal cord, etc.);
- cysts and adhesions;
- pinching of the spinal cord of traumatic origin;
- congenital anomalies of the spine;
- serious curvature and deformation of the ridge (in this case, it sometimes makes sense to resort to such a procedure even without nerve pinching and stenosis).
Post Op Recovery
A proper rehabilitation is extremely important even after a perfectly performed surgery to prevent complications, and fully restore the musculoskeletal functions of the spine and other parts of the musculoskeletal system.
Normally, after surgery, a patient can come back home on the 3rd day. However, since this technique is often part of many other spinal surgery methods, it is possible that hospitalization will last longer. Regardless of the time period of the patient's stay in the hospital, in the future, they will definitely need to register in a good rehabilitation center to receive a quality course of postoperative treatment and physical recovery.
The recovery time after decompressive laminectomy depends on the initial diagnosis, the volume of resection, and the individual characteristics of the patient's body. On average, it takes about 2-4 months to fully recover, but it is usually allowed to return to professional activities not associated with increased physical labor after 3 weeks. The date of the next control diagnostics should be approximately 10-14 days after surgery.
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