There are a wide range of surgical procedures used in spinal surgery. The most extreme includes removing portions of the vertebrae (laminectomy) and inserting either bone chips or metallic devices to cause the bones above and below the surgery site to fuse together. This surgery requires the patient to spend several days in the hospital and is followed by a recovery period that often includes a physical therapy program. On the other end of the surgical spectrum, there is microdiscectomy, a relatively simple outpatient procedure that removes just a small portion of a disc. The correct surgical approach is determined by the size and location of the herniation, or the degree of degeneration. Finding the right surgeon -- one who will take the time to discuss all options and alternatives, and one who has a solid reputation for performing these procedures -- is important to your outcome.
Laminectomy
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Laminectomy is the removal of both sides of the lamina (the bony arch of the vertebrae) so surgeons can gain access to the spinal canal. In this video, Keola Chun, MD, an orthopedic surgeon at Riverside Community Hospital, describes the process. -
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Los Robles Regional Medical Center answeredAfter having a lumbar laminectomy, you will first go to the recovery room for monitoring, where nurses will check your vital signs and incision. You will most likely have a Foley catheter to drain your bladder. This will be removed as soon as you are able to walk to the bathroom safely.
You will have sequential compression devices on your legs that gently squeeze and release your calves. These help prevent the complication of blood clots. You will still have an intravenous line.
You will be transferred to the nursing unit where the staff are specially trained to care for people who have had spinal surgery. You and your family/friends will be introduced to your healthcare staff and briefed on your room. You will most likely have a PCA (patient-controlled analgesia) for pain control. This consists of a button that you as the patient can push when you feel your pain is increasing. It will deliver your pain medication through your IV line. (A safety feature will prohibit you from geting more pain medication than is prescribed, no matter how many times you push the button.)
You will be started with ice chips and then clear liquids. Your diet will be slowly advanced as you tolerate the liquids and begin passing gas. You will most likely rest most of this day in bed. You will be assisted if you need repositioning in bed.
The day after your surgery is considered Post Op Day #1. On this day you should expect to:- walk with physical therapy or nursing
- begin exercises appropriate to your surgery
- have your precautions reinforced -- remember no bending, lifting or twisting
- begin to learn how to perform your daily hygiene and activities while following your spine precautions
- have your dressing changed and possibly have your drain removed
- have your Foley catheter removed
- begin the transition to oral pain medications
- develop a plan for discharge
- move independently and perform daily hygiene and activities following your spine precautions
- walk 50-100 feet
- understand how and when to wear your brace if one has been ordered for you
- have your pain managed by oral pain medications and be able to tolerate a regular diet
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Los Robles Regional Medical Center answeredTo prepare for a lumbar laminectomy, you will need to complete any ordered presurgical lab work, electrocardiogram (EKG) and x-rays. You must not have anything to eat or drink after midnight the night before surgery: no gum, mints, sips of water or coffee. You may brush your teeth. If you have been instructed by your doctor to take a medication the morning of surgery, take it with the smallest sips of water possible.
On the day of the surgery, it's important that you arrive on time and check in. You will need a list of your medications with times and dosages. You will then be taken to a presurgical area where:- your surgical procedure will be confirmed
- you will put on a hospital gown
- you will have an intravenous (IV) line inserted
- you will have a visit from anesthesiologist
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A lumbar laminectomy is the removal of the back part of the bony structure of the vertebra. When the surgeon is removing the bone, some of the nerve roots may need to be moved and/or protected. This movement/protection of the nerve roots may cause you to experience symptoms that you did not have prior to surgery. This may be the cause of the numbness in your feet.