lumbar laminectomy

Lumbar Decompression Surgery Complications and Recovery

Lumbar decompression surgery is used to treat compressed nerves in the lower (lumbar) spine and it is often recommended when all forms of treatment have been attempted without success.

In this article, we will provide a comprehensive overview of Lumbar decompression surgery, possible complications, recovery time, and what you can do to speed it up. 

Why would a person need Lumbar decompression surgery?

There are many back issues that may require Lumbar decompression surgery to help improve or regain mobility and relieve pain. 

These issues are as follows:

A slipped disc – This is when the disc (the soft tissue between the vertebrae) moves out of place and presses down on one of the nerves.

Spinal Stenosis – Stenosis involves the narrowing of the spinal column, which like a slipped disc, applies pressure to the nerves, causing pain.

Sciatica – This is generally caused by a slipped disc but is specific to the unaligned tissue pressing down on the sciatic nerve. 

Metastatic spinal cord compression – This is related to a tumor as a result of cancer, which forces one of the organs, such as the lungs to press against the spinal cord or the nerves around it. This can be very serious and lead to significant complications.

Injuries to the spine – This could include impact injuries, such as a fracture, or tissue swelling. This could be a result of an accident, or a problem that has gradually worsened over time. 

What does Lumbar decompression surgery entail?

If you have sought medical advice and lumbar decompression surgery has been recommended to you, then you will be required to have one of the three procedures below:

Laminectomy – During a Laminectomy, part of, or sometimes all of the vertebral bone (the lamina would be removed. This procedure helps to ease pressure on any affected nerve roots or the spinal cord, this could be related to a spinal injury, metastatic compression, or a condition such as Sciatica as we outlined above. 

A laminectomy would only be advised if the patient has tried a range of treatments that have not helped to ease the pain, or improve their mobility. 

Discectomy – A Discectomy removes part of the lumbar herniated disc in the lower back which is applying pressure to the spinal cord or on a nerve root. 

This generally takes place as a microdiscectomy and requires a specialist microscope to view the problem area. This means the surgeon would only need to make a small incision, reducing the amount of damage caused to any surrounding tissue. 

This procedure may also be combined with a laminectomy. 

Spinal Fusion – Spinal fusion surgery involves permanently connecting two, or multiple vertebrae so they can no longer move. The process works in the same way as broken bone does when it heals, effectively copying a natural occurrence. 

A small piece of bone will likely be grafted from another part of your body to help bridge the vertebrae together, this will then be connected using multiple metal screws, rods, and plates, forming a singular, solid mechanism. 

As the procedures are considered major surgery, you would of course be placed under a general anesthetic so you are unconscious during the entire operation and will not feel any pain. The procedures usually take around an hour to complete but this can be extended if the surgery is particularly complex. 

What are the complications of Lumbar decompression surgery?

The success rate of lumbar decompression surgery is regarded as very high but despite that, the surgery itself does carry some risk and complications, just like any major surgery of this type.

These possible complications can include:

• Possible infections at the site of the operation, which could sometimes spread to other parts of the body. 
• Blood clots could develop in a leg vein which is known as deep vein thrombosis (DVT). Although uncommon, a clot could even detach from the leg and travel to the lungs, resulting in a potentially life-threatening issue, a pulmonary embolism. 
• The procedure could damage one of the spinal nerves or the cord itself which may lead to numbness and weakness in one, or both legs. In extremely rare cases, this has even resulted in some paralysis. 

What is the average lumbar decompression surgery recovery time?

The average time for Lumbar decompression surgery recovery is around four-to-six weeks. 

Of course, this timeframe can differ depending on a person’s general health, the seriousness of the problem before the surgery, and other factors such as disabilities and age. 

A person should be fine to leave the hospital one to four days after the surgery has been completed but this may differ depending on the reasons stated above. 

What can help speed up lumbar laminectomy surgery recovery?

Below are 5 helpful tips to help speed up the recovery time of lumbar decompression surgery:

1. Exercise – Although it is often said that a person recovering from surgery should get plenty of rest, this is somewhat of an outdated theory. Studies show that exercise and keeping active can help get a person back on their feet in less time as it encourages blood circulation.

Keep exercise to a moderate level and do not overexert yourself, avoiding things like weightlifting and contact sports. It may be sensible to get in touch with a physical therapist who can devise an exercise plan for you. 

2. Quit smoking – This is a great time to stop this expensive and life-threatening habit as smoking has been proven to weaken bones and contribute to the degeneration of the spine, significantly lengthening the time needed for it to heal. 

3. Mobility – Walking is one of the best ways to help speed up the healing process as it prevents potential muscle atrophy and blood clots, as well as improving circulation. Try to avoid sitting and lying down for long periods of time. 
4. Diet – While recovering, your body needs food so make sure you eat right and stay healthy. Foods that are high in protein, with plenty of antioxidants are recommended, and avoid foods that are high in sugar or have processed carbohydrates as this can increase inflammation. 

5. Take care of the wound – Do not submerge the wound in water for two weeks after the surgery, instead use a washcloth to gently dab the area and follow all doctor’s instructions.

We hope this guide has been of help and answered any questions you may have about lumbar decompression surgery. 

Lumbar Laminectomy Surgery to Cure Spinal Stenosis

In translation from Greek, stenosis means narrowing. Chronic compression of nerve structures resulting from narrowing the spinal canal is a dangerous, slowly progressive disease. And if earlier the treatment of complex forms included discectomy or decompression, today there is a minimally invasive variant of implantation. 

Stenosis can develop for a long time at the cervical, thoracic and lumbar levels. The spinal cord is located at the first two levels of the spinal column; respectively, the compression will affect its integrity, which is fraught with myelopathy. At the lumbar level, the spinal cord ends at the level of 1-2 vertebrae, but the nerves are compressed in most cases. Often hypoxia (oxygen starvation) of the roots is accompanied by pain and subsequent numbness of the lower extremities, muscle weakness.

To understand the treatment of stenosis, you first need to look at its causes and analyze the types of therapy.

How an innovative alternative compares favorably methods with traditional ones, what is rehabilitation, and are there chances of starting a new life without pain, read further in this article. 

Stenosis reasons

The human spine is a complex structure made up of many elements. The spinal canal is its central part – the spinal cord passes through it, respectively, any pressure from the side of the bone will result in negative consequences on the functioning of such a vital organ.

Spinal stenosis mostly afflicts older people over 60 years old and is an acquired disease. It most often manifests itself at the lumbar level. It can be caused by the development of a herniated disc, tumor, trauma, arthrosis of the facet joints, the growth of osteophytes, disc protrusion, and the consequence of spondylolisthesis. 

Nevertheless, osteoarthritis is the leading cause of changes in the structure of the spinal canal. It consists of wearing out the cartilage tissue and bone growth around the deformed area. That’s how bone spurs (osteophytes) appear, which exert intense pressure on the canal, narrowing it.

By the way, there are cases of congenital (primary) stenosis when the vertebral foramen is underdeveloped. Symptoms begin to appear at a younger age, and compression of the nerve roots can disrupt nerve function and start oxygen starvation of the spinal cord, which leads to pain.

Stenosis symptoms

Depending on the area of the spine where the compression is located, the following symptoms may appear:

1. Stiffness of movement;
2. Numbness and pain in the limbs and back;
3. Lumbar muscle tension;
4. Poor sensitivity;
5. Goosebumps and burning;
6. Urinary incontinence;
7. Uncontrolled defecation act;
8. Decreased libido.

If there is a narrowing in the neck, then the symptoms will spread to the arms, shoulders, shoulder blades, and the back of the head. Conversely, stenosis of the thoracic region is localized in the abdominal cavity and heart.

Please note! The disease manifestations may be reduced by leaning forward, sitting, or stopping and not moving.

Diagnostics

Diagnosis of any disease is impossible without complaints and medical history. Guiding questions about the nature of pain, its localization, the effect on the ability to move, and performing specific exercises will help the doctor recognize the symptoms. Further, using radiography of the spine and magnetic resonance imaging (MRI), bone and cartilage tissue degradation and the degree of narrowing of the canal are established. Sometimes, in complex cases, multispiral computed tomography (MSCT) is prescribed.

Treatment

Treatment of spinal stenosis can be conservative and operative. Conventional therapy includes treatment with analgesics, vascular and anti-inflammatory drugs. However, such a system is often not effective enough. 

The surgical intervention also has several features and can be performed using several approaches:

• decompression laminectomy;
• installation of interspinous fixation systems;
• installation of stabilizing systems.

The decompressive operation involves the resection of structures that compress nerves using a lumbar laminectomy surgery implant. Historically, this type of surgery is considered a traditional approach to treatment. However, it’s already outdated. Many shortcomings are the reason for the lack of effectiveness of the procedure: it involves removing structures that form the supporting column of the spine (Holdsworth). That leads to its instability, and soon the risk of developing unsuccessfully operated spine syndrome. In addition, there are disorders in the biomechanics of the spinal motion segments adjacent to the stabilized ones, which are manifested by their hypermobility. All this leads to the development of spondylolisthesis, spinal stenosis, fractures, scoliosis.

A feature of interspinous dynamic fixation systems is the ability to perform both flexion and extension. In this case, the load on the intervertebral joints is reduced due to the roots decompression by holes enlarging. A contraindication to this procedure is instability in the spinal motion segment. 

Stabilizing systems are constantly improving, but the fact remains: the axial load is evenly distributed between the vertebrae. In this case, the recovery time is minimal, and the effect is the best. It’s essential to understand that, unlike a lumbar laminectomy surgery, an implant has the best chance of restoring the entire range of movements and eliminates a huge number of postoperative complications. 

What results to expect from surgical treatment?

Usually, after surgery, severe pain can last for a month. In the case of fusion, the pain can last 3-6 months! But not in the case of the TOPS™ implant. The fact is that after two weeks, you’ll be able to stop the course of painkillers (read more about this here), as the operation is considered minimally invasive.

To quickly and effectively undergo rehabilitation, both for athletes and older people, it’s essential not to stress the segments. Excess weight lifting (up to 8 pounds), twisting, bending can lead to this. It is crucial to maintain a stable activity level: take short walks, do household chores, and start driving to recover. Within 4-6 weeks, most patients can return to school, work, or play sports.

Conclusions

Stenosis is a pathological narrowing of the spinal canal and compression of the nerve roots. That leads to constant pain in the back and numbness and deterioration of the sensitivity of the limbs. Laminectomy is a traditional method of treating stenosis, but today the technique is considered outdated and unsafe for the patient’s life. Several complications after surgery can provoke the occurrence of spondylolisthesis, fractures, scoliosis, etc. Many physicians choose to use other treatment techniques, although a clear advantage of laminectomy is access to a relatively wide range of movements in case of complete recovery. 

TOPS™ implants have become an alternative to standard surgical stabilization systems and are a breakthrough in medicine. It’s all about the minimal invasiveness, a small amount of risk compared with other manipulations, and most importantly, any movements’ availability without any restrictions. The recovery in this case also occurs relatively quickly, making it possible for the TOPS™ system to become a favorite option among patients.