Lumbar decompression surgery is a type of surgery used to treat compressed nerves in the lower (lumbar) spine.
Few decompression techniques are as follows:
Several combination procedures might be required to perform one specific spinal decompression surgery as per the condition of the patient. In some cases, even spinal fusion is done to stabilise the vertebral column. The physician might suggest any of the above-mentioned procedures for spinal decompression only if none of the non-surgical treatments have helped.
Preparing for surgery
Before the actual spinal surgery, it is important to understand few post-surgery requirements and certain expectations need to be met. Like your own house needs a re-setting of few things within easy reach as post surgery you will not be able to move much and bending over will be restricted as well. So arranging for a grabber can help you grab things sitting or standing at one place will certainly help.
In case you are taking any medications like NSAIDs, Mobic, Diclofenac etc. or any anti-coagulants-coumadin or even Aspirin, then your physician might need to evaluate your condition to stop these meds. Also, instructions about not taking any diabetes medication or diuretic on the day of surgery can be given by the physician. So for discussion of the medication details, a pre-surgery appointment with the surgeon is essential to know the actual instruction manual for the surgery. Few blood or urine tests and even X-rays can be done during this visit prior surgery to confirm everything is fine and you are ready to go for the surgery.
On the day of surgery
In the procedure of Laminotomy or Laminectomy, the patient is made to lie down on the stomach. It can be done by single large incision or with a minimal incision to access the spine by the doctor. Usually, the patients prefer to get the surgery done via small incision if it is possible. In this, the surgeon cuts the lamina to uncover the ligament (ligamentum flavum) to access the spine via a small incision and muscle separation is done instead of cutting them. Then a tube is inserted to create a tunnel through which surgeon performs the surgery. The cause of compression like bulging, a bone spur, and any ruptured or herniated disc is corrected to the possible extent. By doing this the compressed nerves are rectified which connects at the base of the spinal cord in the form of bundles also known as cauda equina.
After this, the surgeon assesses the condition for any further procedures like removal of disc or bone spur (discectomy) or spinal fusion, if required it is also done. Finally, the surgeon closes the incision site which leaves a minimal scar upon healing.
The spinal decompression surgery involves a minimally invasive procedure which allows the patients to get discharged on the same day. However, in some complicated cases patient might require a hospital stay of few days. The patients usually notice immediate improvements in some of the associated symptoms, and other symptoms improve gradually over the time.
At home, proper medication therapy must be followed to help with any sort of discomfort. Also, in case of severe pain which is not managed with the medications or if there appears any temperature and any drainage from the incision site, and increased numbness or weakness then the patient must refer back to the physician immediately.
Post surgery the duration of stay in the hospital is usually 3 to 5 days, depending upon the condition of the patient and the extent to which surgery is performed. Although a lengthy rehab period involving physical therapy might be required.
Although proper recovery process of healing might take from 4 to 6 weeks.
A patient can be a candidate for spinal decompression surgery if:
The candidates for spinal decompression surgery have certain criteria before consideration:
Diagnostic tests include MRI, CT and myelogram which will show your doctor the extent of the damage before surgery. The patient will also be scheduled for presurgical tests (e.g., blood test, electrocardiogram, chest X-ray) several days before surgery. The patient will be advised to stop taking all non-steroidal anti-inflammatory medicines (Naprosyn, Advil, Motrin, Nuprin, Aleve, etc.) and blood thinners (coumadin, aspirin, etc.) one week before surgery.
If lumbar decompression surgery is recommended, there will usually have at least 1 of the following procedures:
Post surgery the duration of stay in the hospital is usually 3 to 5 days, depending upon the condition of the patient. Although a lengthy rehab period involving physical therapy might be required. The proper recovery process of healing might take from 4 to 6 weeks.
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Q: What are the probable risks of spinal decompression surgery?
A: Decompression surgery helps in relieving symptoms like numbness and leg pain. However, there involves a risk to a certain level of blood clots, infection, nerve injury or even paralysis at times.
Q: What is the success rate of the surgery?
A: Usually 70 to 80 percent of the patients have a significant improvement in the quality of life and the associated pain. However, the complete reversal of the symptoms does not occur.
Q: What are the advantages of this surgery over the traditional, open surgery?
A: This involves a minimal incision to perform the surgery in comparison to the old surgery which requires complete opening up to reach the spine.
Q: Is this minimally invasive surgery is still a type of experimental procedure?
A: No, this surgery is being performed with a good success rate for many years from now.
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