Laminectomy usually performed under general anethesia. The patient is placed face-down on the operating table. The exact procedure depends on the location of the problem, for example if it is in the neck, the head is clamped to prevent movement. The skin is marked for incision and the surgeon first cuts through the skin. The muscle is then cut, peeled back from the vertebrae and held in place with special instruments called retractors. The lamina, which is between the bony projection of the vertebrae (the ‘points’ that can be felt with fingers) and the transverse process or ‘wing’, is removed. What happens next depends on the problem. For example, the surgeon may then trim the protruding bits of a herniated disc. Once the surgery is completed, the muscle and skin are sutured (sewn) closed.
Routine post-operative observations will be taken and charted, including temperature and blood pressure. The patient’s wound is checked for redness, swelling and signs of infection. Muscle spasms are quite common following laminectomy. Pain relief is ordered and given regularly. Note is made of ability to pass urine, as sometimes this may be affected immediately following surgery. The patient may have intravenous fluids for a few days, which may include an antibiotic. Initially two people have to help the patient to roll over in bed. The patient is taught the proper method of rolling the body in order to maintain proper body alignment. This is most important for the first 48 hours or so. The patient is assisted out of bed after a few days. A physiotherapist gives specific instructions on how to get out of bed properly in order to avoid stress and strain on the wound site. The patient is encouraged to walk, stand and sit for short periods. The patient is taught how to prevent twisting, flexing or hyperextending the back while moving around.
A regular exercise program following surgery is most important to increase your spinal muscle strength and flexibility, and to protect against future injury. Occasionally, the operation doesn’t work and the original symptoms remain. At other times, the operation isn’t expected to relieve symptoms, but is performed to prevent the area from deteriorating further. In this case, original symptoms will probably remain, but might not get any worse. Some patients may develop chronic back pain after laminectomy surgery, a medical condition known as “postlaminectomy syndrome.” Some surgeons believe that the laminectomy procedure, by removing excessive amounts of bone and ligament from the spine, disturbs the biomechanical stability of the spinal column, resulting in pain.