Laminectomy





Definition

A laminectomy is a surgical procedure in which the surgeon removes a portion of the bony arch, or lamina, on the dorsal surface of a vertebra, which is one of the bones that make up the human spinal column. It is done to relieve back pain that has not been helped by more conservative treatments. In most cases a laminectomy is an elective procedure rather than emergency surgery . A laminectomy for relief of pain in the lower back is called a lumbar laminectomy or an open decompression.


Purpose

Structure of the spine

In order to understand why removal of a piece of bone from the arch of a vertebra relieves pain, it is helpful to have a brief description of the structure of the spinal column and the vertebrae themselves. In humans, the spine comprises 33 vertebrae, some of which are fused together. There are seven vertebrae in the cervical (neck) part of the spine; 12 vertebrae in the thoracic (chest) region; five in the lumbar (lower back) region; five vertebrae that are fused to form the sacrum; and four vertebrae that are fused to form the coccyx, or tail-bone. It is the vertebrae in the lumbar portion of the spine that are most likely to be affected by the disorders that cause back pain.

The 24 vertebrae that are not fused are stacked vertically in an S-shaped column that extends from the tail-bone below the waist up to the back of the head. This column is held in alignment by ligaments, cartilage, and muscles. About half the weight of a person's body is carried by the spinal column itself and the other half by the muscles and ligaments that hold the spine in alignment. The bony arches of the laminae on each vertebra form a canal that contains and protects the spinal cord. The spinal cord extends from the base of the brain to the upper part of the lumbar spine, where it ends in a collection of nerve fibers known as the cauda equina, which is a Latin phrase meaning "horse's tail." Other nerves branching out from the spinal cord pass through openings formed by adjoining vertebrae. These openings are known as foramina (singular, foramen).

Between each vertebra is a disk that serves to cushion the vertebrae when a person bends, stretches, or twists the spinal column. The disks also keep the foramina between the vertebrae open so that the spinal nerves can pass through without being pinched or damaged. As people age, the intervertebral disks begin to lose moisture and break down, which reduces the size of the foramina between the vertebrae. In addition, bone spurs may form inside the vertebrae and cause the spinal canal itself to become narrower. Either of these processes can compress the spinal nerves, leading to pain, tingling sensations, or weakness in the lower back and legs. A lumbar laminectomy relieves pressure on the spinal nerves by removing the disk, piece of bone, tumor, or other structure that is causing the compression.


Causes of lower back pain

The disks and vertebrae in the lower back are particularly vulnerable to the effects of aging and daily wear and tear because they bear the full weight of the upper body, even when one is sitting quietly in a chair. When a person bends forward, 50% of the motion occurs at the hips, but the remaining 50% involves the lumbar spine. The force exerted in bending is not evenly divided among the five lumbar vertebrae; the segments between the third and fourth lumbar vertebrae (L3-L4) and the fourth and fifth (L4-L5) are most likely to break down over time. More than 95% of spinal disk operations are performed on the fourth and fifth lumbar vertebrae.

Specific symptoms and disorders that affect the lower back include:

  • Sciatica. Sciatica refers to sudden pain felt as radiating from the lower back through the buttocks and down the back of one leg. The pain, which may be experienced as weakness in the leg, a tingling feeling, or a "pins and needles" sensation, runs along the course of the sciatic nerve. Sciatica is a common symptom of a herniated disk.
  • Spinal stenosis. Spinal stenosis is a disorder that results from the narrowing of the spinal canal surrounding the spinal cord and eventually compressing the cord. It may result from hereditary factors, from the effects of aging, or from changes in the pattern of blood flow to the lower back. Spinal stenosis is sometimes difficult to diagnose because its early symptoms can be caused by a number of other conditions and because the patient usually has no history of back problems or recent injuries. Imaging studies may be necessary for accurate diagnosis.
  • Cauda equina syndrome (CES). Cauda equina syndrome is a rare disorder caused when a ruptured disk, bone fracture, or spinal stenosis put intense pressure on the cauda equina, the collection of spinal nerve roots at the lower end of the spinal cord. CES may be triggered by a fall, automobile accident, or penetrating gunshot injury. It is characterized by loss of sensation or altered sensation in the legs, buttocks, or feet; pain, numbness, or weakness in one or both legs; difficulty walking; or loss of control over bladder and bowel functions. Cauda equina syndrome is a medical emergency requiring immediate treatment . If the pressure on the nerves in the cauda equina is not relieved quickly, permanent paralysis and loss of bladder or bowel control may result.
  • Herniated disk. The disks between the vertebrae in the spine consist of a fibrous outer part called the annulus and a softer inner nucleus. A disk is said to herniate when the nucleus ruptures and is forced through the outer annulus into the spaces between the vertebrae. The material that is forced out may put pressure on the nerve roots or compress the spinal cord itself. In other cases, the chemicals leaking from the ruptured nucleus may irritate or inflame the spinal nerves. More than 80% of herniated disks affect the spinal nerves associated with the L5 vertebra or the first sacral vertebra.
  • Osteoarthritis (OA). OA is a disorder in which the cartilage in the hips, knees, and other joints gradually breaks down, allowing the surfaces of the bones to rub directly against each other. In the spine, OA may result in thickening of the ligaments surrounding the spinal column. As the ligaments increase in size, they may begin to compress the spinal cord.

Factors that increase a person's risk of developing pain in the lower back include:

  • Hereditary factors. Some people are born with relatively narrow spinal canals and may develop spinal stenosis fairly early in life.
  • Sex. Men are at greater risk of lower back problems than women, in part because they carry a greater proportion of their total body weight in the upper body.
  • Age. The intervertebral disks tend to lose their moisture content and become thinner as people get older.
  • Occupation. Jobs that require long periods of driving (long-distance trucking; bus, taxi, or limousine operation) are hard on the lower back because of vibrations from the road surface transmitted upward to the spine. Occupations that require heavy lifting (nursing, child care, construction work, airplane maintenance) put extra stress on the lumbar vertebrae. Other high-risk occupations include professional sports, professional dance, assembly line work, foundry work, mining, and mail or package delivery.
  • Lifestyle. Wearing high-heeled shoes, carrying heavy briefcases or shoulder bags on one side of the body, or sitting for long periods of time in one position can all throw the spine out of alignment.
  • Obesity. Being overweight, particularly if the extra pounds are concentrated in the abdomen, adds to the strain on the muscles and ligaments that support the spinal column.
  • Trauma. Injuries to the back from contact sports, falls, criminal assaults, or automobile accidents may lead to misalignment of the vertebrae or a ruptured disk. Traumatic injuries may also trigger the onset of cauda equina syndrome.

In this posterior (from the back) lumbar laminectomy, an incision is made in the patient's back over the lumbar vertebrae (A). The wound is opened with retractors to expose the L2 and L3 vertebrae (B). A piece of bone at the back of the vertebrae is removed (C and D), allowing a damaged disk to be repaired (E). (Illustration by GGS Inc.)
In this posterior (from the back) lumbar laminectomy, an incision is made in the patient's back over the lumbar vertebrae (A). The wound is opened with retractors to expose the L2 and L3 vertebrae (B). A piece of bone at the back of the vertebrae is removed (C and D), allowing a damaged disk to be repaired (E). (
Illustration by GGS Inc.
)

Demographics

Pain in the lower back is a chronic condition that has been treated in various ways from the beginnings of human medical practice. The earliest description of disorders affecting the lumbar vertebrae was written in 3000 B.C . by an ancient Egyptian surgeon. In the modern world, back pain is responsible for more time lost from work than any other cause except the common cold. Between 10% and 15% of workers' compensation claims are related to chronic pain in the lower back. It is estimated that the direct and indirect costs of back pain to the American economy range between $75 and $80 billion per year.

In the United States, about 13 million people seek medical help each year for the condition. According to the Centers for Disease Control, 14% of all new visits to primary care doctors are related to problems in the lower back. The CDC estimates that 2.4 million adults in the United States are chronically disabled by back pain, with another 2.4 million temporarily disabled. About 70% of people will experience pain in the lower back at some point in their lifetime; on a yearly basis, one person in every five will have some kind of back pain.

Back pain primarily affects the adult population, most commonly people between the ages of 45 and 64. It is more common among men than women, and more common among Caucasians and Hispanics than among African Americans or Asian Americans.


Description

A laminectomy is performed with the patient under general anesthesia, usually positioned lying on the side or stomach. The surgeon begins by making a small straight incision over the damaged vertebra.

The surgeon next uses a retractor to spread apart the muscles and fatty tissue overlying the spine. When the laminae have been reached, the surgeon cuts away part of the bony arch in order to expose the ligamentum flavum, which is a band of yellow tissue attached to the vertebra that helps to support the spinal column and closes in the spaces between the vertebral arches. The surgeon then cuts an opening in the ligamentum flavum in order to reach the spinal canal and expose the compressed nerve. At this point the cause of the compression (herniated disk, tumor, bone spur, or a fragment of the disk that has separated from the remainder) will be visible.

Bone spurs, if any, are removed in order to enlarge the foramina and the spinal canal. If the disk is herniated, the surgeon uses the retractor to move the compressed nerve aside and removes as much of the disk as necessary to relieve pressure on the nerve. The space that was occupied by the disk will be filled eventually by new connective tissue.

If necessary, a spinal fusion is performed to stabilize the patient's lower back. A small piece of bone taken from the hip is grafted onto the spine and attached with metal screws or plates to support the lumbar vertebrae.

Following completion of the spinal fusion, the surgeon closes the incision in layers, using different types of sutures for the muscles, connective tissues, and skin. The entire procedure takes one to three hours.


Diagnosis/Preparation

Diagnosis

The differential diagnosis of lower back pain is complicated by the number of possible causes and the patient's reaction to the discomfort. In many cases the patient's perception of back pain is influenced by poor-quality sleep or emotional issues related to occupation or family matters. A primary care doctor will begin by taking a careful medical and occupational history, asking about the onset of the pain as well as its location and other characteristics. Back pain associated with the lumbar spine very often affects the patient's ability to move, and the muscles overlying the affected vertebrae may feel sore or tight. Pain resulting from heavy lifting usually begins within 24 hours of the overexertion. Most patients who do not have a history of chronic pain in the lower back feel better after 48 hours of bed rest with pain medication and either a heating pad or ice pack to relax muscle spasms.

If the patient's pain is not helped by rest and other conservative treatments, he or she will be referred to an orthopedic surgeon for a more detailed evaluation. An orthopedic evaluation includes a physical examination , neurological workup, and imaging studies. In the physical examination, the doctor will ask the patient to sit, stand, or walk in order to see how these functions are affected by the pain. The patient may be asked to cough or to lie on a table and lift each leg in turn without bending the knee, as these maneuvers can help to diagnose nerve root disorders. The doctor will also palpate (feel) the patient's spinal column and the overlying muscles and ligaments to determine the external location of any tender spots, bruises, thickening of the ligaments, or other structural abnormalities. The neurological workup will focus on the patient's reflexes and the spinal nerves that affect the functioning of the legs. Imaging studies for lower back pain typically include an x ray study and CT scan of the lower spine, which will reveal bone deformities, narrowing of the intervertebral disks, and loss of cartilage. An MRI may be ordered if spinal stenosis is suspected. In some cases the doctor may order a myelogram, which is an x ray or CT scan of the lumbar spine performed after a special dye has been injected into the spinal fluid.

Lower back pain is one of several common general medical conditions that require the doctor to assess the possibility that the patient has a concurrent psychiatric disorder. Such diagnoses as somatization disorder or pain disorder do not mean that the patient's physical symptoms are imaginary or that they should not receive surgical or medical treatment. Rather, a psychiatric diagnosis indicates that the patient is allowing the back pain to become the central focus of life or responding to it in other problematic ways. Some researchers in Europe as well as North America think that the frequency of lower back problems in workers' disability claims reflect emotional dissatisfaction with work as well as physical stresses related to specific jobs.


Preparation

Most hospitals require patients to have the following tests before a laminectomy: a complete physical examination; complete blood count (CBC) ; an electrocardiogram (EKG); a urine test; and tests that measure the speed of blood clotting.

Aspirin and arthritis medications should be discontinued seven to 10 days before a laminectomy because they thin the blood and affect clotting time. Patients should provide the surgeon and anesthesiologist with a complete list of all medications, including over-the-counter and herbal preparations, that they take on a regular basis.

The patient is asked to stop smoking at least a week before surgery and to take nothing by mouth after midnight before the procedure.


Aftercare

Aftercare following a laminectomy begins in the hospital. Most patients will remain in the hospital for one to three days after the procedure. During this period the patient will be given fluids and antibiotic medications intravenously to prevent infection. Medications for pain will be given every three to four hours, or through a device known as a PCA (patient-controlled anesthesia). The PCA is a small pump that delivers a dose of medication into the IV when the patient pushes a button. To get the lungs back to normal functioning, a respiratory therapist will ask the patient to do some simple breathing exercises and begin walking within several hours of surgery.

Aftercare during the hospital stay is also intended to lower the risk of a venous thromboembolism (VTE), or blood clot in the deep veins of the leg. Prevention of VTE involves medications to thin the blood and wearing compression stockings or boots.

Most surgeons prefer to see patients one week after surgery to remove stitches and check for any postoperative complications. Patients should not drive or return to work before their checkup. A second follow-up examination is usually done four to eight weeks after the laminectomy.

Patients can help speed their recovery by taking short walks on a daily basis; avoiding sitting or standing in the same position for long periods of time; taking brief naps during the day; and sleeping on the stomach or the side. They may take a daily bath or shower without needing to cover the incision. The incision should be carefully patted dry, however, rather than rubbed.


Risks

Risks associated with a laminectomy include:

  • bleeding
  • infection
  • damage to the spinal cord or other nerves
  • weakening or loss of function in the legs
  • blood clots
  • leakage of spinal fluid resulting from tears in the dura, the protective membrane that covers the spinal cord
  • worsening of back pain

Normal results

Normal results depend on the cause of the patient's lower back pain; most patients can expect considerable relief from pain and some improvement in functioning. There is some disagreement among surgeons about the success rate of laminectomies, however, which appears to be due to the fact that the operation is generally done to improve quality of life—cauda equina syndrome is the only indication for an emergency laminectomy. Different sources report success rates between 26% and 99%, with 64% as the average figure. According to one study, 31% of patients were dissatisfied with the results of the operation, possibly because they may have had unrealistic expectations of the results.


Morbidity and mortality rates

The mortality rate for a lumbar laminectomy is between 0.8% and 1%. Rates of complications depend partly on whether a spinal fusion is performed as part of the procedure; while the general rate of complications following a lumbar laminectomy is given as 6–7%, the rate rises to 12% of a spinal fusion has been done.

Alternatives

Conservative treatments

Surgery for lower back pain is considered a treatment of last resort, with the exception of cauda equina syndrome. Patients should always try one or more conservative approaches before consulting a surgeon about a laminectomy. In addition, most health insurers will require proof that the surgery is necessary, since the average total cost of a lumbar laminectomy is $85,000.

Some conservative approaches that have been found to relieve lower back pain include:

  • Analgesic or muscle relaxant medications. Analgesics are drugs given to relieve pain. The most commonly prescribed pain medications are aspirin or NSAIDs. Muscle relaxants include methocarbamol, cyclobenzaprine, or diazepam.
  • Epidural injections. Epidural injections are given directly into the space surrounding the spinal cord. Corticosteroids are the medications most commonly given by this route, but preliminary reports indicate that epidural injections of indomethacin are also effective in relieving recurrent pain in the lower back.
  • Rest. Bed rest for 48 hours usually relieves acute lower back pain resulting from muscle strain.
  • Appropriate exercise . Brief walks are recommended as a good form of exercise to improve blood circulation, particularly after surgery. In addition, there are several simple exercises that can be done at home to strengthen the muscles of the lower back. A short pamphlet entitled Back Pain Exercises may be downloaded free of charge from the American Academy of Orthopedic Surgeons (AAOS) web site.
  • Losing weight. People who are severely obese may wish to consider weight reduction surgery to reduce the stress on their spine as well as their heart and respiratory system.
  • Occupational modifications or change. Lower back pain related to the patient's occupation can sometimes be eased by taking periodic breaks from sitting in one position; by using a desk and chair proportioned to one's height; by learning to use the muscles of the thighs when lifting heavy objects rather than the lower back muscles; and by maintaining proper posture when standing or sitting. In some cases the patient may be helped by changing occupations.
  • Physical therapy. A licensed physical therapist can be helpful in identifying the patient's functional back problems and planning a course of treatment to improve flexibility, strength, and range of motion.
  • Osteopathic manipulative treatment (OMT). Osteopathic physicians (DOs) receive the same training in medicine and surgery as MDs; however, they are also trained to evaluate postural and spinal abnormalities and to perform several different manual techniques for relief of back pain. An article published in the New England Journal of Medicine in 1999 reported that OMT was as effective as physical therapy and standard medication in relieving lower back pain, with fewer side effects and lower health care costs. OMT is recommended in the United Kingdom as a very low-risk treatment that is more effective than bed rest or mild analgesics.
  • Transcutaneous electrical nerve stimulation (TENS). TENS is a treatment technique developed in the late 1960s that delivers a mild electrical current to stimulate nerves through electrodes attached to the skin overlying a painful part of the body. It is thought that TENS works by stimulating the production of endorphins, which are the body's natural painkilling compounds.

Surgical alternatives

The most common surgical alternative to laminectomy is a minimally invasive laminotomy and/or microdiscectomy. In this procedure, which takes about an hour, the surgeon makes a 0.5-in (1.3-cm) incision in the lower back and uses a series of small dilators to separate the layers of muscle and fatty tissue over the spine rather than cutting through them with a scalpel. A tube-shaped retractor is inserted to expose the part of the lamina over the nerve root. The surgeon then uses a power drill to make a small hole in the lamina to expose the nerve itself. After the nerve has been moved aside with the retractor, a small grasping device is used to remove the herniated portion or fragments of the damaged spinal disk.

The advantages of these minimally invasive procedures are fewer complications and a shortened recovery time for the patient. The average postoperative stay is three hours. In addition, 90% of patients are pleased with the results.


Complementary and alternative (CAM) approaches

Two alternative methods of treating back disorders that have been shown to help many patients are acupuncture and chiropractic. Chiropractic is based on the belief that the body has abilities to heal itself provided that nerve impulses can move freely between the brain and the rest of the body. Chiropractors manipulate the segments of the spine in order to bring them into proper alignment and restore the nervous system to proper functioning. Many are qualified to perform acupuncture as well as chiropractic adjustments of the vertebrae and other joints. Several British and Swedish studies have reported that acupuncture and chiropractic are at least as effective as other conservative measures in relieving pain in the lower back.

Movement therapies, including yoga, tai chi, and gentle stretching exercises, may be useful in maintaining or improving flexibility and range of motion in the spine. A qualified yoga instructor can work with the patient's doctor before or after surgery to put together an individualized set of beneficial stretching and breathing exercises. The Alexander technique is a type of movement therapy that is often helpful to patients who need to improve their posture.

See also Disk removal .


Resources

BOOKS

American Psychiatric Association. "Somatoform Disorders." In Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Revised text. Washington, DC: American Psychiatric Association, 2000.

"Low Back Pain." In The Merck Manual of Diagnosis and Therapy , edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 1999.

"Nerve Root Disorders." In The Merck Manual of Diagnosis and Therapy , edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 1999.

"Osteoarthritis." In The Merck Manual of Diagnosis and Therapy , edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 1999.

Pelletier, Kenneth R., MD. "Acupuncture." In The Best Alternative Medicine . New York: Simon & Schuster, 2002.

Pelletier, Kenneth R., MD. "Chiropractic." In The Best Alternative Medicine . New York: Simon & Schuster, 2002.


PERIODICALS

Aldrete, J. A. "Epidural Injections of Indomethacin for Post-laminectomy Syndrome: A Preliminary Report." Anesthesia and Analgesia 96 (February 2003): 463–468.

Braverman, D. L., J. J. Ericken, R. V. Shah, and D. J. Franklin. "Interventions in Chronic Pain Management. 3. New Frontiers in Pain Management: Complementary Techniques." Archives of Physical Medicine and Rehabilitation 84 (March 2003) (3 Suppl 1): S45–S49.

Carlsson, C. P., and B. H. Sjolund. "Acupuncture for Chronic Low Back Pain: A Randomized Placebo-Controlled Study with Long-Term Follow-Up." Clinical Journal of Pain 17 (December 2001): 296–305.

Harvey, E., A. K. Burton, J. K. Moffett, and A. Breen. "Spinal Manipulation for Low-Back Pain: A Treatment Package Agreed to by the UK Chiropractic, Osteopathy and Physiotherapy Professional Associations." Manual Therapy 8 (February 2003): 46–51.

Hurwitz, E. L., H. Morgenstern, P. Harber, et al. "A Randomized Trial of Medical Care With and Without Physical Therapy and Chiropractic Care With and Without Physical Modalities for Patients with Low Back Pain: 6-Month Follow-Up Outcomes from the UCLA Low Back Pain Study." Spine 27 (October 15, 2002): 2193–2204.

Nasca, R. J. "Lumbar Spinal Stenosis: Surgical Considerations." Journal of the Southern Orthopedic Association 11 (Fall 2002): 127–134.

Pengel, H. M., C. G. Maher, and K. M. Refshauge. "Systematic Review of Conservative Interventions for Subacute Low Back Pain." Clinical Rehabilitation 16 (December 2002): 811–820.

Sleigh, Bryan C., MD, and Ibrahim El Nihum, MD. "Lumbar Laminectomy." eMedicine . August 8, 2002 [cited May 3, 2003]. http://www.emedicine.com/aaem/topic500.htm .

Wang, Michael Y., Barth A. Green, Sachin Shah, et al. "Complications Associated with Lumbar Stenosis Surgery in Patients Older Than 75 Years of Age." Neurosurgical Focus 14 (February 2003): 1–4.


ORGANIZATIONS

American Academy of Neurological and Orthopedic Surgeons (AANOS). 2300 South Rancho Drive, Suite 202, Las Vegas, NV 89102. (702) 388-7390. http://www.aanos.org .

American Academy of Neurology. 1080 Montreal Avenue, Saint Paul, MN 55116. (800) 879-1960 or (651) 695-2717. http://www.aan.com .

American Academy of Orthopedic Surgeons (AAOS). 6300 North River Road, Rosemont, IL 60018. (847) 823-7186 or (800) 346-AAOS. http://www.aaos.org .

American Chiropractic Association. 1701 Clarendon Blvd., Arlington, VA 22209. (800) 986-4636. http://www.amerchiro.org .

American Osteopathic Association (AOA). 142 East Ontario Street, Chicago, IL 60611. (800) 621-1773 or (312) 202-8000. http://www.aoa-net.org .

American Physical Therapy Association (APTA). 1111 North Fairfax Street, Alexandria, VA 22314. (703)684-APTA or (800) 999-2782. http://www.apta.org .

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse. National Institutes of Health, 1 AMS Circle, Bethesda, MD 20892. (301) 495-4484. TTY: (301) 565-2966. http://www.niams.nih.gov .


OTHER

American Academy of Orthopedic Surgeons (AAOS). Back Pain Exercises. March 2000 [cited May 5, 2003]. http://www.orthoinfo.aaos.org .

American Physical Therapy Association. Taking Care of Your Back. 2003 [cited May 4, 2003]. http://www.apta.org/Consumer/ptandyourbody/back .

Waddell, G., A. McIntosh, A. Hutchinson, et al. Clinical Guidelines for the Management of Acute Low Back Pain . London, UK: Royal College of General Practitioners, 2000.


Rebecca Frey, Ph.D.

WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?


A lumbar laminectomy is performed by an orthopedic surgeon or a neurosurgeon. It is performed as an inpatient procedure in a hospital with a department of orthopedic surgery . Minimally invasive laminotomies and microdiscectomies are usually performed in outpatient surgery facilities.

QUESTIONS TO ASK THE DOCTOR


  • What conservative treatments would you recommend for my lower back pain?
  • How much time should I allow for conservative therapies to demonstrate effectiveness before considering surgery?
  • Am I a candidate for a laminotomy and microdiscectomy?
  • How many laminectomies have you performed?


User Contributions:

Nora Perrone
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Feb 28, 2006 @ 1:13 pm
Dear doctor: Id like to know if its dangerous to practice a marcial art ( pakua ) after a laminectomy because a certain grade of inestability of the spine and the agressive practice of a marcial art.
Thanks for your opinion
michael
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Jul 31, 2007 @ 3:15 pm
I WILL LIKE TO KNOW WHAT EFFECTS (BAD IF ANY) WILL NICOTINE HAS ON A PATIENT THAT WAS SUBMITTED FOR A LAMINECTOMY ABOUT NINE (9) MONTHS AGO.

PLEASE LET ME KNOW IF THE CIGARETE WILL HARM THE FUNSION OF THE LAMINECTOMY AFTER THE FACT.

THANK YOU IN ADVANCE FOR YOUR ATTENTION ON THIS MATTER.
Gary A. Brody
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Sep 30, 2008 @ 1:13 pm
I had a lumbar laminectomy L2-L3, L4-L5. L4-L5 had ped. screws , and hooks ? to hold my spine in place because of instability. I am having severe pain in the lower section of my lumbar spine feeling like something is stabbing in there. I also have numbness in right leg, burning , tinglting, cramps , sometimes loss of feeling in foot causing me to fall . Had Post Op MRI , EMG , something about mid to lower lumbo, paraspinal denervation? My Neurosurgeon put my on Gabapatenin 300 mgm 3 X day. No relief. Need help please. I am going out of my mind here. Hard to sleep , moving Right leg causes pain at night, and I wake up. I am having more pain now that before my surgery. Please advise I would be ever so grateful.
balaji
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Nov 26, 2008 @ 9:09 am
Dear Doctor, i have undergone spine surgery in the year 2006 in thoracic region. laminectomy done in d4 to d7 level due to nerve compression and since then i am not able to walk. can you please help me out is there any specific exercises or some alternate therapy which helps me to become a normal person and in my back there is lot of spasm also. My doctor says that i may walk in future but cant say when. please help me out i will be ever grateful to you.
CHERYL SPRENGER
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Aug 26, 2009 @ 10:22 pm
How much does a simple laminectomy and spinal cost approximately in the Sacramento area?
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Jun 2, 2010 @ 1:13 pm
I just found out i need a decompression in my lower lumbar already have a double fusion in c3-4-5-5-6 and now it has put so much pressure on bottom i am compressesd and am falling down alot and the pain is so intense that it is 24/7 so i am at the end of my rope i have had a total of 9 surguries and now stat comp is taking away my meds i have been on for 15 years without weaning me off so i am going thru withdrawls also. i too take gabapatenin but i am taking 800 mg 4xday and it helps. Have your dr up your dosage i know when i forget to taks it as it helps my nerve pain but i have to be on hightest dose i feel your pain 15 years for me and i pray this decompression helps me i also have that knife in my back its like they twist it more everytime u go to the drs for help they need to start listining to their patients. Good luck to u i cant type anymore it hurts so let me know what happens
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Jul 26, 2010 @ 6:18 pm
I had the same thing happen to me. After two years of worsening pain, I finally went to a different surgeon for an opinion. He ordered new fims and found a calcium deposit had been left behind during the surgery. He removed the calcium deposit and the fusion bar and screws and had to fuse three additional vertebrae above the fusion that had gone bad. It has been one year since the operation and I have no back pain. See a couple of different surgeons and get another opinion. I bet they may be able to h elp you.
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Aug 7, 2010 @ 3:03 am
My husband is advised for a laminectomy due to diffused disc bulge and compression of nerve roots. How will be the life after the surgery? Can he come back to the normal life style of doing the daily activities? Will this problem in the spine reoccur later in his life with the other vertebra or spinal bones?
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Oct 8, 2010 @ 9:09 am
My neurosurgeon has recommended laminectomy after my having an MRI scan.I do not have much problem with my back but my problem starts with my feet. I have constant pins and needles and numbness in my feet.It gets aggravated if I stand and when I start walking. Within a few minutes of walking this numbness starts travelling up my legs and right up to my buttocks and lower back and I can not feel anything. So much so I lose control of my legs and feet and I have to sit and stop walking to avoid falling.Please advise. could this be due to circulation in my legs/feet or anything else! Is laminectomy the answer?
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Nov 29, 2010 @ 12:12 pm
I am worried about my husband's latest laminectomy he had 1 to5 cervical laminectomy last year 2009 +recovered well but then deteriorated so he could hardly walk. Now he has had 6+7 done + developed a leak of spinal fluid + has had a catheter for 4 days . I voiced my worries but the doctors say it is within normal recovery times ,but unlike last year he has only walked with help about 4 times.Has anyone experience of this or am I panicking too soon! Thanks Helen Jones
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Dec 4, 2010 @ 9:09 am
Following my questions on 29th November my husband no longer has the catheter but has had 3 spinal leaks + now a lumbar drain inserted for 5 days although he can walk he is now not allowed to Anyone with experience of this please Email hmjones434@aol.com .Staff are helpful but not able to allay my fears Thanks Helen Jones
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Dec 29, 2010 @ 7:07 am
wow... this is a great information.. it is easy to understand and very specific... thank you. i learn a lot today by reading this page. :)
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Apr 22, 2011 @ 11:11 am
My 82 year old father had a laminectomy ten weeks ago and has been unable to empty his bladder since. He has to self catheter four to five times per day. He does have some flow and is taking Flomax but cannot empty his bladder. Is this common post surgery? Is this a permanent condition? He had no bladder issues pre-surgery with bowels or bladder.
Thank you,
Cynthia Engdahl
barbara zehren
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Sep 11, 2011 @ 12:12 pm
Had a lumbar laminectomy 3 weeks ago. 1 lamin was removed. Was told not to bend, except from the hips, reach, lift more than 5 lbs or twist. i am 79yrs.old,live alone. Will start PT in 3 weeks but am on my own as far as figuring out methods for accomplishing ADL. Have figured out obvious such as moving much used objecs to reachable heights, using the "pick up tool", a small stool to get at some lower cabinets etc. Only hope I'm doing all this correctly. Any advice or books you could reccomend for my immediate needs?
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Oct 22, 2011 @ 5:17 pm
I had laminectomy lumbar surgery two weeks ago. L4-5 & S1
I still had pain. Even worse than before some off time. Lump on area of incision.
Dr sent me to get a MRI. They said I have a blood clot on the area that he remove bone to open up spine.
What does this mean. Dr is out of town.
Sandra Dalton
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Oct 26, 2011 @ 9:09 am
I had a sacral laminectomy in 2009 for removal of Tarlov cysts. My pain has been much worse since surgery. It was suggested by a physical therapists that I now have the 5 plates and 10 screws removed that were placed in my sacral spine during surgery, which could be interfering with healing. Is this ever done?
Sandra Dalton
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Oct 26, 2011 @ 9:09 am
I had a sacral laminectomy in 2009 for removal of Tarlov cysts. My pain has been much worse since surgery. It was suggested by a physical therapists that I now have the 5 plates and 10 screws removed that were placed in my sacral spine during surgery, which could be interfering with healing. Is this ever done?
Roy Morgan
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Oct 27, 2011 @ 1:13 pm
I was wondering if this has happened to anyone out there: I had a large blood clot in my left leg and a massive blood clot in my left lung. The Dr rushed me to the ICU at the hospital and put in a central line in my neck for giving drugs and drawing blood. The Dr told me i needed a dose of the blood clot buster. I don't know the name he said it was like liquid drano. After a week in the hospital i was put on warfarin. I rested a couple weeks like the Dr told me to do and when i started walking for a while my lower back was killing me. Now more Dr's MRI tests. Everyone agreed and sent me to a surgeon. Now he says the only way i was going to get better was to have a lumbar laminectomy. So i finally agreed. After another week in the hospital when i went home my back hurt worse than it did. Anyway mr family Dr said i had failed back surgery syndrome. Now 3 yrs later i don't work i don't hardly go anywhere. A rel life changer,i was at my job 28.3 yrs. Does anyone know if that clot buster drug could have dissolved the 2 clots and some how 1 lodged in my back? I never had back trouble before that. I always wondered if the clot or the drug was to blame for my trouble. I have asked all my DR's and no one seems to know. Thanks for anything someone has to say.
Roy
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Oct 30, 2011 @ 12:12 pm
I HAD A CERVICAL THORACIC LAMINECTOMY FOR REMOVAL OF TUMOR (SCHWANOMA) AND SPINAL FUSION THREE YEARS AGO. I AM EXPERIENCING STRANGE SYMPTOMS SUCH AS SKIN AND SCALP ITCHIN, SKIN IRRITATIONS AND A PRICKLY FEELING., CHILLS, SWEATING, (NO FEVER) HEADACHE SOMETIMES NAUSEA THIS HAPPENS ABOUT EVERY 2 TO 3 WEEKS. I FEEL VERY SICK AND GET A TREMBLING INSIDE AND GENERAL MALAISE. I"VE BEEN TO MANY, MD'S ' DERMATOLOGISTS HAD BLOOD TESTS OF ALL KINDS, NO ONE FINDS THE ANSWERS. SHOULD I SEE MY NEUROLOGIST. PLEASE HELP ME. I CANNOT SLEEP WHILE THIS IS HAPPENING
Rose Pabellon
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Dec 21, 2011 @ 9:09 am
Last year I had Spinal fusion surgery and this year I had decompression lamenectomy surgery with the Dr. removing the old rod putting in a longer one a grafting and opening the bottom of my spine now 4 months later I'm having lower back chronic pain and my left buttock cheek is going numb and a cramp from my side to the middle of my lower spine but I fell forward on the cement side walk and for the last three weeks I can't get much sleep and the pain is unbeareable at times I believe the fall has strained or pulled a muscle or strained something could that be possible?
Sharon Jeffers
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Jan 6, 2012 @ 11:11 am
I had a Lumbar laminectomy done 12yrs ago, i have recently gained some weight and began experiencing some lower back pains is it possible for me to skip as a form of exercise
Heather
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Jan 12, 2012 @ 5:17 pm
Dear Doctor, I am on my 5th - 6th week of healing from a an L4-L5 fusion and some hardwear was put in. I walk every day but also have an SI issue that will be operated on soon. My concern is that I do too much in that bending over to put away or get out items (groceries/pots/ect.). I am causious in that when I do get these items that I stay straight go to knees then deal with the item. But after 10 mins of this I am in agony. How much walking/exercise should I be doing? I know that with the SI issue I am limited in what I can do because of the pain from my lower back/butt into hip/thigh and then the knee but stops there. I see my surgeon next week but am wondering these things now and am stressing out. Also, how much weight am I allowed to handle? I can't sleep for long, stand for long, walk for long, or sit for long periods of time so I am always moving.

Thanking you in advance, for your anticipated response and taking the time to answer and straighting me out!!
shuja
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Mar 9, 2012 @ 8:08 am
hi im 23yera's old so i was in stries with my family pshychologically problem so one night i was fight with some one and i was so much hupper and i sad that person i want to kill my self and then i juped from 1st floor may be its 6meter when i was jumped in my two legs and dat time i want to stand up so i heard one voice of my backbone thn some people took me i sad them leave me here and call the ambulanse but one heard me they took me again to the ssame place then ambulance come then i make operation my lower back bone so it put platinium in my backe bone . now my question is can it be normal or not? thanks
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Aug 6, 2012 @ 3:03 am
I had a c2 to c6 laminectomy 7 weeks ago as i have lost feeling in both hands this surgery has not inproved this for me
?do you think its early or what do you think went wrong
?do you have any ideas or advise for me
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Jun 13, 2013 @ 6:18 pm
Had surgery in Feb 13 and again in May. Purpose was to release pressure causing pain down legs, probably pressure on nerves.(scraped bone) First did not work so did the second. Doc scraped bone on both sides. Now I cannot even walk wirhout a walker or holding on to things. Things pop when I bend over even slighty. Am in pain most of the time. My husband sets his watch to wake me up every 4 hours to take pain meds. If not I cannot function at all when I wake up and meds get into my system. I am so disappointed and so afraid that I my never walk again. What could have happened that I now cannot even walk? Doc doesn't seem to be too interested, Office says I cannot see him until 9 July. Should I seek other Spinal Offices?
Kathlene
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Oct 14, 2013 @ 9:09 am
Hi eluzabeth i would like to help you. i have done my surgery 6 weeks ago mine was thorasic laminectomy t-5, t-6. everything went well with the operation thanks god my tumor is now gone. by now u should be doing normal things but avoid heavy things but for ur period u have to be well now. my mom and i are very thankful because we found a very good doctor.

Hi mildred cope go see other doctor u need that. have 2nd even 3rd or 4th opinion to make u feel better. so far im happy with my operation. i even ask my doctor today if when i can go back to running and swimming and he said yes but in a moderate way like brisk walking not running and swimming is still the best exercise to our condition. i wish u well and wish to help u.
Randy
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Jun 15, 2014 @ 7:19 pm
I am scheduled for my 3rd bi-lateral laminectomy on July 10th 2014. I have antrolesthesis and retroesthesis as well as spinal stenosis, narrowing of the foramina bone, spurs, herniated disks, and facet degeneration. This is at the L3 L4 vertebral junction. It has been 11 years since my last surgery and I understand they are also going through my side to put additional stabilizing hardware at the joint. Does anyone know about the additional hardware I am talking about? What is the recovery time for a 53 year old having this type of surgery? I have nobody to help me at home if I were to fall, so should I consider a skilled nursing facility for any length of time?

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