A laminectomy is a type of back surgery also known as decompression. The vertebras, or bumpy portions of the spine, are covered by lamina. This lamina helps to protect the spinal column and the cord canal and offers support for nerves branching out from the spinal cord to other parts of the body.
Back injury, inflammation, swelling or other conditions involving the bony processes of the spinal column place pressure against the spinal cord and nerves. This can cause pain, stiffness, limited range of motion, or immobility in certain areas of the body. A laminectomy is a procedure that removes a portion of this covering from the spinal column, giving the bones more room, as well as relieving pressure on the spinal cord or its nerves.
Anyone diagnosed with a herniated or slipped disc may benefit from a laminectomy. The procedure relieves pressure thereby reducing pain and complications caused by pinched nerves. Laminectomy procedures are often performed on individuals diagnosed with spinal stenosis as well as herniated discs, sciatica and other conditions that affect movement and mobility.
For a laminectomy procedure, patients are put under general anesthetic. This means the patient will be asleep and won't feel anything during the surgical procedure. During the surgery, the patient’s overall condition will be monitored by members of the surgical team. The patient is placed on his or her stomach for most types of laminectomy surgery, but exact positioning will be determined by the surgeon.
An incision is made in the back over the spinal column in the area affected. A laminectomy may be performed on the cervical, thoracic or lumbar portions of the spine. The size of the incision is determined by the surgeon or by the number of vertebrate affected and the type of procedure.
The surgeon inserts a small instruments that scrapes or removes portions of the lamina that cover the vertebrae. If the surgery is performed due to a herniated disc diagnosis, the surgeon will also remove broken pieces of or the entire disc, and replace it with a prosthetic.
In the case of spinal stenosis, the surgeon may perform spinal fusion, or the process of adhering one vertebra to another using screws, metal rods or bone grafts to help stabilize and support the spinal column.
Today, most laminectomy procedures are performed laparoscopically, which results in smaller incisions and reduced healing time. The laparoscope is an instrument shaped like a long metal straw. A camera is attached to one end that enables the surgeon to view the operating field underneath the skin using a monitor or computer screen in the operating room. Additional surgical instruments will also be utilized through small incisions to complete the procedure.
Following the removal of adequate amounts of lamina, the surgeon irrigates the surgical field and then closes the incision with stitches or staples. The patient is then returned to his or her hospital room to recover.
Following surgery, the patient may be required to stay in the hospital for up to three days, and a physical therapist will talk to the patient about post-surgical movements and exercise. In most cases, patients can resume gentle exercises within 4 to 6 weeks, but are cautioned against resuming normal activities for up to three months.
Cost of laparoscopic laminectomy procedures will depend on location and approach. In the United States, any type of spine surgery is quite expensive. In the U.S. for example, a lumbar laminectomy may cost approximately $25,000, including a hospital stay and the surgeon's fees and the anesthesia fees. The fee for the operating room itself may go as high as $15,000. The average cost of the laminectomy itself is roughly $8,000. An individual traveling to India may spend approximately $4,500 on laminectomy while a patient traveling to Thailand will spend approximately $6,000.
A laminectomy procedure is generally performed by an orthopedic surgeon specializing in spine care or neurosurgeon as well as a vascular or general surgeon trained in laparoscopic procedures. Surgeons should be chosen according to their expertise and experience in related fields. Physicians and surgeons should be certified in their field, and show membership in national or regional boards or associations in his or her country of origin. Consumers are encouraged to get more than one opinion before engaging in any type of spinal surgery, as well as making sure that facilities, surgeons, and healthcare staff are accredited by international associations and organizations to ensure quality of equipment, technology, as well as quality of care by medical staff.
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