What is Laminectomy?Laminectomy is a surgical intervention, which is done for the removal of a portion of the bony arch, or lamina, on the dorsal surface of a vertebra. The objective of this surgery is to relieve back pain that has not been helped by more conservative treatments. Rather than an emergency surgery Laminectomy is an elective procedure.
When is Laminectomy recommended?Laminectomy is recommended when one or more of the following symptoms and disorders that affect the lower back are seen in the body:
- Sciatica. In this condition there is sudden radiation of pain from the lower back through the buttocks to the back of one leg. Also the patient may experience accompanying sensation of a tingling feeling, or a "pins and needles" type sensation.
- Spinal Stenosis. Narrowing of the spinal canal results in Spinal stenosis disorder and thereby compressing the cord.
- Cauda equina syndrome (CES). When a broken disk, bone fracture, or spinal stenosis put intense pressure on the spinal nerve roots at the lower end of the spinal cord, it results in this syndrome. Symptoms include loss of sensation in the legs, buttocks, or feet accompanied with pain, numbness and weakness in one or both legs. It may also result in failure in controlling urination or bowel movements.
- Herniated disk. The fibrous outer part of the disks between the vertebrae in the spine is called the annulus and it has a softer inner nucleus. The soft gel inside is pushed through the wall of the disk, when one of these disks herniates i.e. moves out of its place causing pressure on the spinal cord and nerves that comes out of the spinal column.
- Osteoarthritis: in Osteoarthritis disorder the cartilage in the hips, knees, and other joints gradually breaks down, in turn allowing the surfaces of the bones to rub directly against each other.
How does the procedure work?In Laminectomy procedure the positioning of the patient is on the side or stomach and this procedure is performed under general anesthesia. Over the damaged vertebra a small straight incision is made and a retractor is inserted. This instrument is used to spread apart the fatty tissues and the muscles which are covering the spine, to reach to the laminae. Then there is a bony arch before the which is a band of yellow tissue attached to the vertebra that helps to support the spinal column.this bony arch is also cut to reach to the ligamentum flavum. Finally to reach the spinal canal and then to the compressed nerve an opening is made in the ligamentum flavum. At this point the cause of compression is visible (that may be a herniated disk, tumour, fragmented disk etc) which is then rectified. This Surgery is completed in one to three hours.
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