Laminectomy: what is it and what are its risks?

Laminectomy is a surgery that is also called open decompression. It consists of removing the back of a vertebra (call sheet) to create more space in the spinal canal.

The spinal column is made up of 33 vertebrae, separated from each other by the intervertebral discs. They are cartilaginous discs that cushion the shock between these bones. A laminectomy is done to relieve excessive pressure on the canal that could damage the nerves or spinal cord.

It is a procedure that it is usually used in patients with arthritis of the spine. Although it is usually a safe technique, it carries risks and important aspects to consider. In this article we explain everything you need to know about laminectomy and how it is performed.

What is a laminectomy?

Laminectomy, as we just noted, is a surgical technique performed on the spine. It consists of removing a part of one or more vertebrae. The portion that is removed is called sheet.

It is also named as open decompression because through it it is possible to relieve the pressure on the spinal nerves and the spinal cord. In most cases, it is done when other treatments have been insufficient, such as physical therapy or medications.

The increase in pressure can be due to pathologies such as osteoarthritis, herniated discs or tumors. The idea is that when the nerves are compressed, pain, mobility disturbances and even loss of sphincter control often appear.

The relief procedure is performed by cutting into the back. Through the incision, part of the vertebra or vertebrae that are causing the condition are removed. Once this is done, the part of the disc that has herniated is removed.

The nerves and muscles are returned to their original position and the cut is closed. This way, increases the space of the spinal canal. If the injury affects the neck, the approach is usually done anteriorly.

In some cases, the technique is combined with others, such as arthrodesis, so that the spine does not lose stability. Arthrodesis consists of fusing two vertebrae together, preventing them from moving.

The structure of the spine is susceptible to causing pinching and injury to the nerves, which is accompanied by pain and even mobility disorders.

Why is it done?

Laminectomy is performed to relieve excess pressure within the spinal canal. This increased pressure is usually associated with excessive bone growth in the vertebrae. It occurs, for example, in arthritis and osteoarthritis.

The problem is that the pressure damages the spinal cord and spinal nerves. These patients usually suffer a lot of pain, the location of which varies depending on which area is affected. In addition, there may be weakness, numbness, and loss of bowel control.

Laminectomy it is usually reserved for cases in which less aggressive treatments have failed. For example, when analgesic drugs do not relieve pain or physical therapy does not improve other symptoms.

It is also usually indicated when the severity is very noticeable. That is, when the patient's daily activities are affected. If you cannot control the sphincters, walk or stand, a laminectomy is used.

As explained by specialists from the Mayo Clinic, it is a technique that can be used to treat herniated discs. Especially those in which the damaged disk cannot be accessed. Lumbar stenosis is another of the main reasons for its prescription.

You may be interested: How stress can affect our spine

What are the risks of a laminectomy?

Laminectomy is considered a safe technique. However, we must bear in mind that the spine is a complex and delicate structure. In addition, like any other surgery, it is associated with a series of possible complications.

For example, there may be bleeding, blood clots, or wound infection. During this intervention it is possible that some of the spinal nerves are damaged. This could leave sequelae, such as weakness, numbness, or even paralysis.

There may also be spinal fluid leakage or tears in the fibrous tissue that covers and protects the cord. These complications require, in most cases, a second surgery.

How to prepare for a laminectomy

Before performing a laminectomy, it is essential that the patient knows all aspects of the intervention. The safest thing is that certain treatments will have to be suspended or modified beforehand.

In addition, the day on which the intervention was scheduled It will be necessary to avoid eating or drinking liquids in the hours before it. It is recommended to seek help for the following days, since activities such as cooking or even cleaning can be complex.

You might be interested in: Diagnosis and treatment of spinal osteoarthritis

What happens during laminectomy

As explained in an article by the corporation WebMD, the laminectomy is performed under general anesthesia. Therefore, the patient must be intubated during the procedure. The normal thing is that the operation is carried out by means of a cut in the back, unless it is desired to treat the cervical spine.

Through the incision the tissues are dissected to reach the affected vertebrae. The surgeon will remove the bone spurs or lamina that are compressing the nerves. In some cases, several different bones may need to be removed.

Similarly, as we discussed at the beginning, laminectomy may be combined with other techniques. For example, with an arthrodesis to stabilize the spine. If there is a herniated disc, the affected disc will likely be removed as well (the technique is called discectomy).

After surgery

Laminectomy is a procedure of variable duration. Although in some cases the patient can go home the same day of the intervention, the most common is that they remain hospitalized for at least a few days. This way you can see if any complications appear.

Right after the intervention, the patient is transferred to a recovery room. There it is examined if the sensitivity and mobility are adequate. It is normal for there to be pain in the intervened area.

In addition, the recovery is progressive. It usually takes a week to get back to normal activities. Even, the first days walking can be difficult, lift things or move. Physical therapy is usually recommended after laminectomy.

Cervical laminectomies are slightly different from the rest, due to the anatomical structures of the neck.

Expectations regarding the procedure

Laminectomy is considered a safe procedure. In most cases, the pain prior to the intervention is significantly reduced. At least the one that affected the limbs.

When the recovery is complete (about 2 or 3 months), the operated patients reveal a great improvement. Nevertheless, some symptoms may reappear over the years. Especially if the underlying pathology progresses.

Because, in some cases a second intervention is necessary. Most of the time it is done because stenosis reappears in another part of the spine or the spine is unstable.

Laminectomy is a complex procedure

It is true that, in most cases, laminectomy produces a very significant improvement in symptoms. However, this treatment is usually reserved for people in whom other less aggressive treatments have failed.

The main reason is that, although it is considered a safe technique, it is not without risks. For this reason, the doctor should always be the one to advise what is the most appropriate approach for each patient, depending on their health conditions.