The goal is to relieve symptoms associated with pressure on the nerve root. Often, the pain relief is instant and patients wake up after the surgery feeling marked relief of their leg pain.
If neurological symptoms had also been experienced prior to surgery, it may take longer for the nerve to heal and the patient may continue to feel some weakness or numbness, or any of their prior symptoms, for several months or up to a year. For some, the symptoms may improve but never fully resolve. See Lumbar Microdiscectomy Surgery. A lumbar laminectomy is the surgery most commonly performed to treat lumbar spinal stenosis symptoms.
This pressure can cause pain, weakness or numbness that can radiate down your arms or legs. Because the laminectomy restores spinal canal space but does not cure you of arthritis, it more reliably relieves radiating symptoms from compressed nerves than it does back pain from spinal joints. In some situations, laminectomy may be necessary as part of surgery to treat a herniated spinal disk. Your surgeon may need to remove part of the lamina to gain access to the damaged disk.
Laminectomy is generally a safe procedure. But as with any surgery, complications may occur. Potential complications include:. You'll need to avoid eating and drinking for a certain amount of time before surgery. Your doctor can give you specific instructions about the types of medications you should and shouldn't take before your surgery. Surgeons usually perform laminectomy using general anesthesia, so you're unconscious during the procedure.
The surgical team monitors your heart rate, blood pressure and blood oxygen levels throughout the procedure. After you're unconscious and can't feel any pain:.
After surgery, you're moved to a recovery room where the health care team watches for complications from the surgery and anesthesia. You may also be asked to move your arms and legs. The surgeon makes an incision cut over the affected section of spine down to the lamina bony arch of your vertebra , to access the compressed nerve. The nerve will be pulled back towards the centre of the spinal column and part of the bone or ligament pressing on the nerve will be removed.
To complete the operation, the surgeon will close the incision using stitches or surgical staples. A discectomy is carried out to release the pressure on your spinal nerves caused by a bulging or slipped disc.
As with a laminectomy, the surgeon will make an incision over the affected area of your spine down to the lamina. The surgeon will gently pull the nerve away to expose the prolapsed or bulging disc, which they'll remove just enough of to prevent pressure on the nerves.
Most of the disc will be left behind to keep working as a shock absorber. To complete the operation, the surgeon will close the incision with stitches or surgical staples. Spinal fusion is used to join 2 or more vertebrae together by placing an additional section of bone in the space between them.
This helps to prevent excessive movements between 2 adjacent vertebrae, lowering the risk of further irritation or compression of the nearby nerves and reducing pain and related symptoms. The additional section of bone can be taken from somewhere else in your body usually the hip or from a donated bone. More recently, synthetic man-made bone substitutes have been used. To improve the chance of fusion being successful, some surgeons may use screws and connecting rods to secure the bones.
Afterwards, the surgeon will close the incision with stitches or surgical staples. Your surgeon can give you more information about which procedures are going to be performed during your surgery. Spinal decompression surgery is usually performed through a large incision in the back. This is known as "open" surgery. To improve the chance of fusion being successful, some surgeons may use screws and connecting rods to secure the bones. Spinal decompression surgery is usually performed through a large incision in the back.
This is known as "open" surgery. In some cases, it may be possible for spinal fusion to be carried out using a "keyhole" technique known as microendoscopic surgery. This is performed using a tiny camera and surgical instruments inserted through a small incision in your back.
The surgeon is guided by viewing the operation on a video monitor. Microendoscopic surgery is complicated and isn't suitable for everyone. Whether it's suitable for you depends on the exact problem in your lower back. There's also a slightly higher risk of accidental injury during this operation than with an open operation.
Some of the techniques used during microendoscopic surgery, such as using a laser or a heated probe to burn away a section of damaged disc, are relatively new. Therefore, it's still uncertain how effective or safe they may be in the long term. An advantage of microendoscopic surgery is that it usually has a much shorter recovery time. In many cases, people can leave hospital the day after surgery has been completed. Recovery after lumbar decompression surgery will depend on your fitness and level of activity prior to surgery.
This is why a course of physiotherapy before the operation may be recommended. It will take about 4 to 6 weeks for you to reach your expected level of mobility and function this will depend on the severity of your condition and symptoms before the operation.
When you wake up after lumbar decompression surgery, your back may feel sore and you'll probably be attached to one or more tubes.
Immediately after surgery, you'll have some pain in and around the area where the operation was carried out. You'll be given pain relief to ensure you're comfortable and to help you move. The original leg pain you had before surgery usually improves immediately, but you should tell the nurses and your doctor if it doesn't.
A very small number of people have difficulty urinating after the operation. This is usually temporary, but in rare cases complications, such as nerve damage, may cause the legs or bladder to stop working properly.
It's important to tell your doctor and nurses immediately if you have problems. It can take up to 6 weeks for the general pain and tiredness after your operation to disappear completely.
You'll have stitches or staples to close any cuts or incisions made during your operation. Deep stitches beneath the skin will dissolve and don't need to be removed.
If dissolvable stiches are used, they don't need to be removed. Non-dissolvable stitches or staples will be removed 5 to 10 days after your operation. Before you leave hospital, you'll be given an appointment to have them removed. Your stitches may be covered by a simple adhesive dressing, like a large plaster. Be careful not to get your dressing wet when you wash.
After having your stitches removed, you won't need a dressing and will be able to bath and shower as normal. Your medical team will want you to get up and moving about as soon as possible, usually from the day after the operation.
This is because inactivity can increase your risk of developing a blood clot in the leg DVT , and movement can speed up the recovery process. After your operation, a physiotherapist will help you safely regain strength and movement. They'll teach you some simple exercises you can do at home to help your recovery. You'll usually be able to go home about 1 to 4 days after your operation.
How long you need to stay in hospital will depend on the specific type of surgery you had and your general health. When you get home, it's important to take things easy at first, gradually increasing your level of activity every day. Some help at home is usually needed for at least the first week after surgery. Being active will speed up your recovery. Make sure you do the exercises recommended by your physiotherapist, and try not to sit or stand in the same position for more than minutes at a time, because this can make you feel stiff and sore.
Walking is a good way to keep active, but you should avoid heavy lifting, awkward twisting and leaning when you do everyday tasks until you're feeling better. You may be asked to return to hospital for one or more follow-up appointments in the weeks after your operation to check how you're doing. When you can go back to work will depend on how quickly you heal after surgery and the type of job you do.
Most people return to work after 4 to 6 weeks, if their job isn't too strenuous. If your job involves a lot of driving, lifting heavy items or other strenuous activities, you may need to be off work for up to 12 weeks. Before starting to drive again, you should be free from the effects of any painkillers that may make you drowsy. You should be comfortable in the driving position and be able to do an emergency stop without experiencing any pain you can practise this without starting your car.
Some insurance companies don't insure drivers for a number of weeks after surgery, so check what your policy says before you start to drive. Lumbar decompression surgery is generally effective in relieving symptoms such as leg pain and numbness. However, up to 1 in 3 people continue to have symptoms after surgery, or develop symptoms again within a few years of surgery. Recurrent symptoms can be caused by a weakened spine, another slipped disc, or the formation of new bone or thickened ligament that puts pressure on your spinal cord.
Scarring around the nerves can also sometimes develop after surgery, which can cause similar symptoms to nerve compression. Non-surgical treatments, such as physiotherapy, will usually be tried first if your symptoms recur, but further surgery may sometimes be needed. Repeat operations have a higher risk of complications than first-time operations.
0コメント