You might have neural tissue damage if you are facing issues like pain or numbness around your shoulder blade area or have problems in controlling or emptying your bladder. In such cases, you might need laminectomy surgery. Keep reading to know more about the laminectomy procedure.

A laminectomy is a surgical procedure that clears space in the body by eliminating bone spurs and tissues linked to spine arthritis. Typically, a tiny portion of the lamina, the rear of the spine's small bones, is removed (vertebrae). Laminectomy enlarges the spinal canal to relieve strain on the spinal cord or nerves and is frequently performed along with decompression surgery.

Bony overgrowths inside the spinal canal, which can happen in persons with spinal arthritis, are the most frequent cause of this pressure. Bone spurs are another name for these growths. For some people, they are a complication of getting older.

Laminectomy is often reserved for cases where less invasive therapies, including medication, physical therapy, or injections, have failed to provide relief from its symptoms. If symptoms are severe or significantly worsening, laminectomy may also be advised.

A medical professional might advise laminectomy if:

• There are no improvements in the reduction of symptoms by conventional therapies such as medication or physical therapy.
• Standing or walking becomes challenging due to muscle weakness or numbness, and symptoms include loss of bowel or bladder control.
• One can also require laminectomy as part of the surgical procedure to correct a herniated spinal disc. In order to access the damaged disc, a surgeon might have to remove a portion of the lamina.

A low back or neck ache may be dull, somewhat bothersome, or persistent, severe, and incapacitating. Your ability to move and do daily activities may be hampered by back pain. Doctors perform a laminectomy to address a disc issue, relieve pressure on the spinal nerves, or remove a tumour from the spine.

A disc may become dislodged or harmed due to trauma or normal wear and tear. The spinal nerves are compressed by the disc, which results in discomfort and, occasionally, numbness or weakness. The affected body, usually the arms or legs, will experience numbness or weakness. Sciatica is the most typical sign of a herniated disc. From the buttocks to the thigh and down the back of the leg, a strong, shooting pain travels along the sciatic nerve.

Laminectomy presumably relieves the pressure contributing to the radiating discomfort since it restores spinal canal space. However, the surgery does not treat arthritis that leads to constriction. As a result, it is unlikely to reduce back pain.

There are three types of laminectomy procedures performed by doctors:

• Cervical Laminectomy: Surgeons perform this procedure on a cervical vertebra in the neck.
• Lumbar Laminectomy: This is a procedure for the vertebrae present in the lower back. It helps relieve pain in the buttocks, lower back and legs.
• Sacral Laminectomy: Doctors remove the lamina on the fused sacral vertebrae under this procedure.

There are a few guidelines doctors may provide to prepare you for the laminectomy procedure:

• Refrain from taking any blood-thinning medicines
• Quit smoking
•  Do not drink or eat anything a few hours before the procedure
• Keep food, clothes, utensils and all daily-necessary things in an easily accessible place
• Arrange for a brace and other supportive devices to use at home later
• Prepare transportation or ask someone to help you get back home from the hospital after the procedure.

Similar to other surgical procedures, laminectomy too can involve some risk factors. The laminectomy procedure risk factors are as follows-

• Bleeding
• Spinal cord or nerve root injury
• Blood clots in the lungs or legs
• Infection
• Risks linked to the use of general anaesthesia

In the surgical area, blood vessels or nerves could be hurt. This could result in numbness or weakness. Although it is uncommon, the operation might not reduce the pain or even worsen.

Here are a few ways to prepare yourself for a laminectomy process. 

• Your healthcare professional will walk you through the surgery and give you the chance to ask any questions you may have.
• You need to sign a consent form giving the go-ahead for the procedure. If something on the form is unclear, thoroughly read it and then ask questions.
• Your healthcare professional may conduct a physical examination and take a thorough medical history to ensure that you are in good health before the surgery. You might undergo diagnostic testing such as blood tests.
• Inform your healthcare practitioner if you have any drug sensitivities or allergies, including those to latex, tape, and anaesthetic medications (local and general).
• Inform your doctor about all prescription, over-the-counter, and herbal supplements you are taking.
• If you have a history of bleeding disorders or are on any blood-thinning (anticoagulant), aspirin, medications, or other medications that alter blood clotting, let your doctor know. Your doctor might advise you to discontinue taking these medications prior to the surgery.
• Inform your healthcare practitioner if you suspect you might be pregnant or are already pregnant.
• If you are instructed to refrain from eating or drinking before surgery, abide by those instructions.
• Before the procedure, you will receive a sedative to help you unwind.
• A physical therapist may visit with you before surgery to discuss recovery.
• Following your operation, some activities could be restricted. Make plans for someone to assist you with driving and domestic chores for a few days.
• Your healthcare practitioner can give you additional instructions depending on your health.

Typically, a laminectomy necessitates a hospital stay. The procedures could change depending on your situation and your doctor's methods.

Your surgeon will perform a laminectomy while you are under general anaesthesia. Alternatively, they can use spinal anaesthetic, which means you are still conscious but won't feel anything below the waist. Newer methods are being researched that would make it possible to do a laminectomy as an outpatient under local anaesthetic.

A laminectomy procedure steps are as follows:

• After instructing you to take off your clothes, they will hand you a gown to wear.
• Your surgeons will use your arm or hand to start an intravenous (IV) line.
• They can also implant urinary drainage once you're sedated.
• The hair may be trimmed off if it is covering the surgical site.
• You will be lying on your stomach on the operating table.
• Throughout the procedure, the anaesthesiologist will keep a close eye on your breathing, blood oxygen level, blood pressure and heart rate.
• The medical team will use an antiseptic solution to clean the surgery site's skin.
• Your surgeon will make a cut (incision) over the chosen vertebra and separate the muscles.
• To relieve pressure on the nearby nerves, the surgeon removes the bony arch of the posterior section of the vertebra (lamina). This could entail removing disc material entirely or in part, as well as bone spurs or other growths.
• Occasionally, your doctor might also carry out spinal fusion concurrently. A spinal fusion involves the surgeon joining two or more of your spine's bones.
• They will close your incision site with surgical staples or stitches.
• Lastly, the team of surgeons will cover your incision site with a dressing or sterile bandage.

After the surgical procedure, you will undergo the recovery process. The primary recovery takes place in the hospital. Then, after you reach home, you have to be under rest and proper medication to fully recover. The following are the details on what you can expect after a laminectomy procedure.

At the Hospital

You will be brought to the recovery area for observation following the procedure. Your doctor's team and staff will bring you to your hospital room as soon as your breathing, blood pressure, and pulse stabilise and you awake. You will typically need to spend one or more days in the hospital following a laminectomy.

The evening following your surgery, you'll probably start getting out of bed and moving about. You will receive medication to manage your pain so you may participate in the exercise. Your doctors might also ask you to follow an exercise regimen to adhere to both while you're in the hospital and after you leave.

At Home

It's crucial to keep the surgical wound area clean and dry once you get home. You will receive special bathing instructions from your healthcare practitioner. Your doctor will remove the surgical staples or stitches during a subsequent appointment visit.

If you feel sore, follow your doctor's advice and take a pain reliever. Aspirin and a few other painkillers may increase the chances of bleeding, so make sure to only take prescribed medications.

Inform your medical professional if you face any of the following:

• Fever
• Bruising, bleeding, or other discharge at the site of the incision
• Increased discomfort near the incision site
• Your legs, back, or buttocks feel numb.
• Loss of bladder or bowel control or difficulty urinating

Drive only after you receive the all-clear from your healthcare professional. Avoid bending over or arching your back when picking up items. You could be advised to minimise other activities by your healthcare provider.

Depending on your health condition, your healthcare professional might offer you additional advice after the treatment.

If looking for alternatives to the laminectomy procedure, there are some options you can consider before consulting a doctor for surgery:

• Effort for Self-Improvement: Things like losing weight, applying a hot and cold compress, taking proper rest, using a TENS machine, or doing mindful meditation can help relieve symptoms of spinal stenosis.
• Medications: Doctors can suggest medication to relieve pain, but it will not address the cause of the disease. These mainly include painkillers, steroid injections, and antidepressants.
• Advice From Expert: There are other professionals you can take advice from, like physiotherapists, chiropractors, acupuncturists, osteopaths, psychologists, and massage therapists.
• Less Invasive Methods: You can also try other less invasive procedures like a neurotomy, pain management program, intrathecal pain pump, spinal cord stimulator, and more.

The cost of going through a laminectomy procedure in India ranges between ₹ 2,30,000 to ₹ 3,90,000. However, it can vary from one city to another and the hospital you take assistance from.

That is all for the laminectomy procedure. Knowing well about the procedure before your surgery will keep you informed about what is happening with your body.