Sunday, April 14, 2024

Recovery From Lumbar Decompression Surgery

Are There Risks To Lumbar Laminectomy Surgery

Recovery Series: Recovery After Lumbar Microdiscectomy

Since a laminectomy is a spinal procedure, it carries some risks. Some complications may include blood clot formation, postsurgical infection, nerve damage, breathing problems, or adverse reactions to medication/anesthesia. Despite the risks, the great majority of laminectomy surgeries are successful and uneventful.

Metastatic Spinal Cord Compression

Cancer in one part of the body, such as the lungs, sometimes spreads into the spine and presses on the spinal cord. This is known as metastatic spinal cord compression.

Initial symptoms can include:

  • back pain, which may be mild at first, but usually gets worse over time the pain is constant and often worse at night
  • numbness in your fingers and toes
  • problems urinating

Without treatment, metastatic spinal cord compression is potentially very serious and can result in permanent paralysis in the legs.

For people in good enough health to withstand surgery, metastatic spinal cord compression is best treated with surgery. However, if the problems only become apparent late on, many people are too ill to withstand or benefit from surgery.

Why Is Spinal Decompression Surgery Performed

Your doctor may recommend spinal decompression surgery to treat severe symptoms of spinal nerve compression or symptoms that dont improve well enough with more conservative treatments, such as physical therapy.

A variety of diseases, disorders and conditions of the spine can lead to pressure on the spinal cord or nerve roots including:

  • Bone spurs, which are abnormal growths of bone on a vertebra
  • Degenerative disc disease, which is a breakdown of the intervertebral discsmade of a cartilage-like substance, collagen, and other connective tissuesthat provide cushioning for the vertebrae above and below them.
  • Herniated disc, which is a displacement of an intervertebral disc. Other names for this condition include bulged disc, slipped disc, and ruptured disc.
  • Scoliosis, which is an abnormal spinal alignment causing an s-shaped curvature
  • Spinal stenosis, which is a narrowing of the spinal column, usually due to arthritis. Foraminotomy and laminectomy are common spinal decompression surgeries for spinal stenosis.

Other possible causes of spinal nerve compression include infections, injuries and tumors.

Depending on the cause of the compression, symptoms may take years to develop or they may come on very suddenly. Symptoms also vary depending on the location of the disease or injury in the spine, such as the neck or lower back. Common symptoms include pain that may radiate or spread to other areas, burning, tingling, numbness, weakness, and problems with balance or coordination.

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Lumbar Laminectomy: What To Expect After Surgery

A lumbar laminectomy is a surgery that treats compression of the spinal cord in your lower back. The surgery involves removing all or part of your vertebra called the lamina.

The lamina is the part of your vertebra that connects the body to the spiny part you can feel along your neck and back.

An estimated 200,000 or more U.S. adults have spinal nerve compression in their lower back, which is also called lumbar spinal stenosis. Doctors usually try to treat it with nonsurgical methods first, but they may recommend laminectomy or another surgery if those methods arent effective.

Keep reading to learn more about lumbar laminectomies, including what happens during the procedure, how long it takes to recover, and if there are any potential side effects.

procedures for decompressing the spinal cord and nerve roots. Its usually the procedure of choice for middle aged and older adults with compression caused by degeneration.

Benefits Of Minimally Invasive Back Surgery

Microdiscetomy

Minimally invasive back surgery or minimally invasive spine surgery uses smaller incisions, a fiber-optic camera, and small specialized surgical tools. The muscles and soft tissues surrounding the spine are left intact. A minimally invasive approach usually means surgeries are completed earlier, patients spend less time in the hospital, there is less postoperative pain, and the recovery time is shorter.

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Slipped Disc And Sciatica

A slipped or herniated disc is where the tough coating of a disc in your spine tears, causing the jelly-like filling in the centre to spill out. The torn disc can press on a surrounding nerve or nerves, causing pain in parts of your legs.

This pain may be accompanied by tingling, pins and needles, numbness or weakness in certain areas of your legs. The pain is often referred to as sciatica and is sometimes worse when straining, coughing or sneezing.

The most common characteristic of sciatica is pain that radiates out from the lower back, down the buttocks and into one or both legs, right down to the calf. The pain can range from mild to severe.

A slipped disc can occur at any age, but is more common in people from the ages of 20 to 40. If a disc becomes damaged, it sometimes only takes an awkward twist or turn, a minor injury or even a sneeze to cause the filling in the centre of the disc to spill out.

However, the exact cause of a slipped disc is often unknown.

Procedures Used For Spinal Decompression

There are three procedures that are widely used for spinal decompression surgery. They include:

  • Partial discectomy

On occasion, spinal fusion may be used as a means of stabilizing the areas of the spine that were treated, adding a fourth procedure to the mix.

As laminectomy is the most commonly performed procedure for this treatment, the spinal decompression surgery recovery time will be outlined for a laminectomy.

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How Long Will It Take For Your Activity Levels To Return To Normal

In the days right after your spinal decompression surgery, your focus will be on rest and recovery. However, you should still make sure to get up and walk for a little bit each day. This can help speed up the healing process. As you start to get stronger, you can increase your activity level by little bits each day. Your surgeon or physical therapist may give you specific exercises to do during spinal decompression surgery recovery. These can help strengthen your back as you heal and keep your muscles from getting stiff or sore.

To avoid injuring yourself, listen to your surgeons recommendations and try not to push yourself too hard. Other guidelines you may follow during your recovery include:

  • Do not drive for at least two weeks after your surgery.
  • Dont ride in a car for longer than 30 minutes at a time for the first two to four weeks.
  • Avoid bending at the waist or lifting your arms above your head.
  • Dont sit or stand in one position for longer than 30 minutes at a time. Staying active can help reduce your back pain while you heal.
  • Dont start any heavy household chores, such as laundry or vacuuming, before your doctor says youre ready.
  • Avoid strenuous exercise, such as jogging, biking, or swimming, until your surgeon says it is okay.

Rehabilitation: A Necessary Step

Spinal Stenosis – Full-endoscopic decompression at the lumbar spine with VERTEBRIS stenosis

The team of physiotherapists at Instituto Clavel is used to dealing every day with patients recovering from spinal surgery. Manual therapies and rehabilitation exercises are crucial to helping those patients get back their quality of life.

Among the exercises that the specialist may prescribe following spine surgery are those that combine lumbar flexion with strength and elasticity, with the goal of gradually strengthening the muscles. Ideally, this rehabilitation should begin soon after surgery.

Physical therapy will also allow you to learn to the right way to move and carry out your daily activities in a way that keeps your back in a safe position and prevents pain. Some of the activities youll probably have to learn to do differently are as follows:

  • Getting up safely from bed or a chair
  • How you dress and undress
  • Youll need to do some exercises that strengthen the muscles of the back to keep it stable and safe.

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Surgical Techniques & Postoperative Rehabilitation

All surgical procedures employed the endoscopic transforaminal approach using the outside-in technique and employs a foraminoplasty in patients with or without lateral stenosis for the treatment of herniated disc. The author has published the details of the surgical decompression of this study group of patients elsewhere . Most patients did not require postoperative rehabilitation and supportive care requirements. Some patients were treated for postoperative irritation of the dorsal root ganglion with nonsteroidal anti-inflammatories, gabapentin, and TESI to treat any dysesthetic leg pain syndromes.

What Are The Risks Of Back Surgery

Back surgery can carry higher risks than some other types of surgery because it is done closer to the nervous system. The most serious of these risks include paralysis and infections.

Even with a successful surgery, the recovery time can be long. Depending on the type of surgery and your condition before the surgery, healing may take months. And you may lose some flexibility permanently.

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What Results Can I Expect From Lumbar Decompression Surgery

Laminectomy is very successful at relieving much of the pain and numbness that was caused by the nerve and/or spinal cord compression. Any weakness in the extremities that was linked to the compression should, for the most part, be alleviated. Laminectomy is better at improving leg pain caused by a compressed nerve than back pain.

However, the surgery wont stop the process of aging on the spine. Plus, if spinal osteoarthritis was to blame, surgery wont stop future buildup of bony growths. But, in the vertebra where the lamina was removed, a return to compression is unlikely.

What Recovery Looks Like

Lumbar Support Brace, Adjustable Spinal Decompression Back Belt Fusion ...

Complete recovery from MISS can take anywhere from three to six months, with many patients being able to return to light activities a week after surgery. During the early stages of recovery, patients are advised to focus on giving their bodies time to heal. Preparations help patients have a more comfortable recovery. Here is what your recovery will likely be like:

Recovery may look different from patient to patient, as factors such as the patientâs overall health, preparation and adherence to doctorâs instructions, and the specific surgery performed can affect the experience and outcomes.

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How To Prepare For Your Lumbar Laminectomy Surgery

The preparation for this surgery is the same as any major surgery. We ask that you refrain from taking any non-steroidal, anti-inflammatory medicines, and certain supplements 10 days before your surgery such as:

  • Aspirin, Advil, Aleve

If you have a physician who recommends that you do not stop taking aspirin prior to surgery, please be sure to discuss this with our office. If you smoke, youll need to stop for at least two weeks prior to your surgery. This helps strengthen your immune system and overall healing.

How Can I Prepare Myself For The Operation

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health. Nicotine is known to prevent wounds from healing properly following lower-back surgery, and increases the risk of unsightly scarring and chronic pain.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

If you have not had the coronavirus vaccine, you may be at an increased risk of serious illness related to COVID-19 while you recover. Speak to your doctor or healthcare team if you would like to have the vaccine.

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When Will You Start Feeling Pain Relief After Your Surgery

Right after your procedure, youll probably feel some pain in the area near your surgical incisions. Youll be given pain medication to help you manage your discomfort as you heal. Even though youll be dealing with pain from the surgery, you should quickly notice some relief in any leg or arm pain that was caused by the pinched nerve in your back.

After spinal decompression surgery, most patients see the fastest rate of pain relief in the first six weeks after their procedure. Any feelings of tingling or prickling should steadily decline in the three months after your surgery. If you were experiencing numbness in your arms or legs before your procedure, that should slowly go away over the next year.

The pain from the surgery itself should be gone within six weeks. You can expect your energy levels to return to normal around that time too. However, this does not mean that your spine is finished healing. Depending on your specific situation, that can take anywhere from three months to a year.

Recovery And Precautions At Home Following Lumbar Laminectomy

Terry – 4 Level Lumbar Decompression & Fusion Surgery L2-3, L3-4, L4-5,L5-S1

During the first few weeks or months at home, exercises and activity restrictions must be followed. The at-home exercises are usually provided by the treating physical therapist. A few at-home procedures post-surgery are:

  • Pain management. Pain management includes the use of medications as well as limiting and modifying activities to prevent excessive pain. Medications may include:
  • Pain-relieving medications. Pain-relieving medication such as opioids may be given for a few weeks to manage post-surgical pain. These medications are advised to be used for short-term with gradual tapering of dosage to prevent addiction. It is important to note that nonsteroidal anti-inflammatory drugs are not advised after a laminectomy surgery because these may delay bone healing.3
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  • Incision care. It is advised to avoid activities such as bathing, swimming, and hot-tubs until the incision site has completely healed. Proper care of the incision can prevent rupture of sutures, infection, or other complications. If suture removal is required, this may be done 1 to 2 weeks after surgery at the surgeonâs office. Absorbable sutures usually dissolve within a week.
  • Physical therapy. It is necessary to continue with the physical therapy program and follow the prescribed exercises as instructed. Vigorous activities such as running or lifting heavy weights are not advised.

    See Rehabilitation and Exercise Following Spine Surgery

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    What Happens Immediately After Your Spinal Decompression Surgery

    After your surgery, youll be moved to a recovery room. There, your medical team will monitor you as your anesthesia wears off. If your procedure is performed at an outpatient surgery center, youll go home later that day. If it is performed in a hospital, your surgeon may keep you there for one to four days. During this time, your medical team will monitor your recovery.

    The incisions from your spinal decompression surgery will be closed with stitches or staples. After your procedure, they will be covered with a sterile dressing to protect them as they heal. If your surgeon uses dissolvable stitches, you wont have to go back to get them removed. If they use staples or non-dissolvable stitches, youll need to go back in five to ten days to have them removed.

    During your spinal decompression surgery recovery, if you notice your wound becoming warm, opening up, getting more red or swollen, or draining extra fluid, you should .

    When its time for you to go home after your surgery, you will not be able to drive yourself. So, before your surgery, you should make arrangements to have someone ready to pick you up when youre discharged. Your surgeon will probably advise you to recline your car seat on the way home.

    Who Is A Good Candidate For A Lumbar Decompression Surgery

    When a vertebra develops a growth such as a bone spur within the spinal canal, it shrinks the space available for the spinal cord and the nerves. This can create pressure on those nerves that causes pain, weakness, or numbness that can radiate down the patients arms and legs. If not treated, the compression can lead to loss of function and permanent nerve damage.

    A laminectomy may also be necessary in herniated disc surgery to gain access to the damaged disc.

    Dr. Albert may recommend a laminectomy if:

    • Conservative treatments such as physical therapy dont improve symptoms
    • You have muscle weakness or numbness that is making walking or even standing difficult
    • You are experiencing loss of bladder and bowel control

    Dr. Albert is without a doubt, the most gifted, competent and skilled spinal surgeon a patient could ask for. He is truly warm, compassionate, responsive to the needs of his patients and very caring. Dr. Albert performed a Lumbar Laminectomy a few months ago, and I am happy that I selected him to perform the procedure. Clearly, I have total confidence and trust in Dr. Albert, and he is a credit to the Hospital for Special Surgery.

    Thank you Dr. Albert!

    S.N.

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    Central Spinal Stenosis: The Basics

    Your spinal cord is the main nerve that runs from your brain down your spine. It runs through a hole in the middle of each vertebra called the spinal canal.

    Gradual wear and tear of your vertebrae and conditions like herniated discs can compress your spinal cord. Compression in your lower back can cause the following symptoms:

    • pain and stiffness in your lower back
    • burning pain down your legs
    • numbness and weakness in your legs
    • loss of sensation in feet
    • loss of bladder or bowel control
    • loss of sexual function

    Typically during a laminectomy, the surgeon will remove the entire rear of a vertebra. This procedure can be performed on one or more vertebrae. If only one lamina is removed, the procedure is called a hemilaminectomy. If only part of the lamina is removed, its called a laminotomy.

    When one of the laminae is cut, but the rear of the vertebra isnt removed, the procedure is called a laminoplasty.

    Surgeons use several different surgical techniques to perform a laminectomy. They can do it as an open surgery, which is most common, or as a minimally invasive procedure called microlaminectomy, which is performed under microscopic magnification with a smaller incision.

    In a 2017 study , researchers found that microlaminectomy was associated with shorter hospital stays and reduced costs in a small group of people. The researchers speculated that the shorter hospital stays were due to a reduction in post-surgery pain and avoiding the need for a wound drain.

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