Treatments

What is a Lumbar Laminectomy?

Medical terminology doesn’t go out of its way to be complicated or hard to understand. It’s simply that the language has to be very precise, and that much of it comes from Latin. Hence, it can be difficult to decipher some med-speak without a little help. Take the term “lumbar laminectomy,” a fairly common surgical procedure that can help alleviate the pain, mobility limitations, and other symptoms that often accompany medical conditions of the lower spine. Indeed, the word “lumbar” refers to the lower spine. The lumber portion of the spine comprises the lowest five vertebrae of the spinal column, which bear the designation L1 through L5 – “L” standing for lumbar.

Every vertebra in the spinal column is covered in a bony sheath called the lamina, which helps protect

the nerves that run through the spinal column. But sometimes, due to injury, disease, degenerative changes, or other causes, the lamina can put pressure on nerves emanating from the spinal column, a condition referred to as a pinched nerve. Problems within the vertebrae, such as an unnatural narrowing of the spinal canal, a condition called spinal stenosis, can also result in pinched nerves.

When surgery is performed to relieve pressure on a pinched spinal nerve, a procedure called spinal decompression, it requires cutting away the portion of the lamina that is impinging on a nerve or to gain access to the interior of the vertebrae to address a condition such as spinal stenosis. In medicine, the suffix “ectomy” refers to excision or removal. Thus, cutting away a portion of the lamina is a procedure called a laminectomy. So a lumbar laminectomy is an operation in which a portion of the lamina on one of the first five vertebrae is trimmed away. A lumbar laminectomy can achieve dramatic results in alleviating the symptoms of pinched nerves. Traditionally, spinal fusion back surgery was performed in concert with a laminectomy to stabilize the spine at the point of the operation. Now lumbar laminectomy patients have an alternative that provides better outcomes than spinal fusion surgery while preserving the full range of the spine’s motion: The TOPS (Total Posterior Spine) System procedure. If you’re a candidate for a lumbar laminectomy or other spinal decompression procedure, make sure you understand all your treatment options.

What is a Laminectomy 

Lumbar Laminectomy is a spinal surgery involving the removal of the vertebral bone to alleviate symptoms of spinal stenosis. Laminectomy surgery is relatively common for major surgery. Its main function is to reduce spinal pressure on the cord and nerve roots when they are being unnaturally restricted. This surgery is for those suffering from various ailments, including those sustained from past injuries, herniated disks, spinal stenosis, and tumors. While there are alternative methods to try before getting to this point, such as physical therapy, medication, and even injections, some may find this is the only path to relief.

While determining what is a laminectomy, we should deconstruct the name. Lamina is the scientific name for the vertebral bone. This surgery, Lumbar Laminectomy, is the process of removing the vertebral bone to lift pressure surrounding the spinal canal. Pressure is created by things like impacted bone injury, bone overgrowth, or growing tumors. A decompressive laminectomy increases available space and therefore alleviates any pain sufferers may be experiencing. While the surgery itself is great, so are the results. 

What is Spinal Stenosis

If you are considering spinal laminectomy you may likely be suffering from spinal stenosis. Spinal stenosis is one of the most common spinal ailments. Since stenosis means narrowing or restricting, this condition refers to the unnatural narrowing of the spinal canal. This condition often develops for unknown reasons but can be caused by an overgrowth of either bone or tissue. Some cases may be hereditary, while others arise from an unhealthy lifestyle. 

Options Before Surgery

Everyone can benefit from a healthy lifestyle, including those suffering from spinal stenosis or other spine stemming pain. Simple solutions like a healthy diet, regular exercise, and maintaining a healthy BMI can all reduce pain and symptoms. While these are idealistic options, they also are not the solution for everyone. It is possible that someone’s back pain is so great they are limited in the forms of exercise they can partake in.

Physical therapy is another noninvasive option that patients can try before getting a lumbar laminectomy surgery. Because most patients suffer from pain in their back and legs, it can be helpful to have a physical therapist to assist in teaching the body how to move through these debilitating pains in a way that can offer some relief. Physical therapy assigned exercises to have the ability to release pressure similar to surgery, though the effects are often not as long-lasting. 

Medication is also available to those suffering from inescapable pain. Some medications offered can help with both pain and inflammation so that those suffering from spinal stenosis are able to manage their symptoms throughout their day.

While these solutions can help manage and relieve pain, ultimately, they do not offer more stability to a destabilized spine, nor do they permanently create space in the spine where the pressure afflicts. In cases of long-term relief, most find that surgery is necessary to moving forward into a pain-free life.

Laminectomy Surgery

In deciding if surgery is right for you, it helps to know exactly what is to be expected during the procedure. A doctor uses general anesthesia to put the patient under for the duration of the surgery. In the process of the surgery, the surgeon makes a small cut into the back, right over the affected area. They then enter through this cut with small tools to lift the muscle away from the spinal column. The lamina is then removed to create space in the narrowed spinal canal.  In the case of a herniated disk, the doctor can then remove the parts of the disk that have herniated. 

Traditionally after this, the vertebrae would be fused to create stability in the spine to supplement the removed lamina. This is done with either bone graphs, screws, or metal rods. While efficient in rendering the spine functional post-operation, it does create limited mobility that can impede some physical activities.

How to Prepare for Laminectomy Surgery

Laminectomy Surgery is major surgery. Many are intimidated by spinal surgery because it is such a crucial part of our body and people often have a fear of how their life changes after. Here is how to prepare for optimal recovery.

• Consider your new mobility while you recover. With a limited range of motion, you should consider buying a pair of slip-on shoes to avoid bending down and straining.
• Ensure frequently used items are in easy-to-access spots. This may look like lowering things from high shelves as well as heightening objects that previously required bending over to reach them. Remember, this is temporary.  Once healed you should be able to reach all these things again without any pain or discomfort. 
• Do some meal prepping. The less work you have to do while recovering the quicker you heal. This also means you can rely less on others and be more self-sufficient in a time when you may feel dependent on others.
• Finally, on the day of the surgery, make sure you fast before going in. Like most surgeries that require general anesthesia, you are advised to stop eating and drinking by midnight the night before. Some water is allowed the morning of the surgery, but a full stomach can pose complications once you are under.

Laminectomy Recovery

Once you wake from the surgery your care team checks to ensure everything has gone smoothly and your body has responded well to the spinal laminectomy surgery. While a short hospital stay is typical, some people are released the same day. This means that no matter the case, the comforts of home are not too far away.

Upon returning home, rest! Though it is healing in the long run, your body has just sustained a major injury and needs time and care to recover. Give yourself grace and let people help with things like meals and keeping the house running. Letting yourself rest at this time is crucial for long-term recovery.

It is recommended that you do not work for the first few weeks following a decompressive laminectomy. Those with less physically demanding jobs return to work sooner than those with more labor-intensive jobs. If you have a spinal fusion laminectomy recovery takes longer.

How to Make Spinal Surgery Less Traumatic

The results of lumbar laminectomy, while impressive, may take a while to work. There are records of patients taking up to a full year to complete their laminectomy recovery. Those who do go through with the surgery are also sometimes recommended physical therapy as a part of their recovery process.  This leads to a long and involved path back to normalcy.

If you are looking for a way to make your laminectomy surgery and recovery less traumatic, consider a spinal implant. TOPS system uses an implant after decompression is completed to prevent the necessity for spinal fusion. Where traditionally vertebrae are fused after laminectomy surgery, TOPS implants hold the space where the vertebrae were removed, combining the relief of the surgery with all the mobility and freedom you had before. 

Regain your mobility with Premia Spine! Contact us now

Patients who have had a TOPS System implant report faster and easier laminectomy recoveries than those who received traditional spinal fusions. Because the spine is the foundation of the human body it is important you take the path offering the greatest recovery and mobility post-surgery. Does this look like a spine that has been fused together, or upgraded with an implant?

Life After Laminectomy

While it is a big decision to make, ultimately it comes down to regaining your life. Those who have spinal laminectomy are choosing a life free of debilitating pain and getting back the body they once knew. Lumbar laminectomy patients are often happier and healthier, having chosen the care right for them.

Back Pain and Steroid Injections

Epidural injections of steroids have often been the treatment of choice for patients with a pinched nerve in the back whose symptoms did not respond to simple exercise, physical therapy, or other more conservative approaches. Steroid injections have also been offered to patients with spinal stenosis whose back pain was unrelieved by less invasive therapy. But the results of a new research study hint that injections of steroids for back pain may be less beneficial than believed. The study is small, but it still bears consideration, as the findings are statistically valid and underscore why healing is as much an art as a science.

The study of the efficacy of steroid injections for back pain examined more than 270 patients, aged 53 to 75 years old, culled from the ranks of a larger study of individuals with spinal health problems. The research subjects were followed for four years. Sixty-nine of these patients had epidural injections and 207 did not, but otherwise the patients’ symptoms were primarily the same in terms of severity, as measured by well-established scales used to measure pain in the leg and lower back. Using these scales, researchers found less improvement among those who had epidural injections than among patients who did not have injections.

Several caveats must be offered when considering the results of this research. First, as the authors readily acknowledge, factors that the researchers didn’t account for and couldn’t control may have affected or skewed the results. Nonetheless, we are seeing fresh thinking and new techniques improving outcomes for many spinal patients. For example, patients who elected to have spinal decompression surgery to relieve symptoms of pinched nerves typically opted for a spinal fusion back surgery in tandem, in order to stabilize the spine. Today, a growing number are opting for TOPS^TM – the Total Posterior Solution – System, instead of spinal fusion. The TOPS system, unlike spinal fusion, preserves complete independent motion of the individual vertebrae. This is one more way that fresh thinking, and new technologies and procedures are transforming the care and treatment of back problems.

What Is Back Strain? Symptoms, Causes, Treatment of Back Strains

Though it’s commonly played down, a back strain can be an extremely painful and demobilizing injury. Hearing “It’s just a back strain” may not be very comforting when you’re experiencing severe back pain, and while back strain may sound like a minimal back injury, it can cause a great deal of discomfort.

A back strain can result in sleepless nights and back spasms that can cause severe lower back pain. In some cases, back strains can lead to immobility. 

Read on to learn more about back strains and how to alleviate the symptoms of this common condition. 

What is a back strain?

A back strain is a common injury that occurs when the muscles or ligaments in the lower back become stretched or torn. This causes inflammation that may lead to back spasms, eventually causing persistent back pain.  

Understanding what a back strain is can help you better determine how to care for your back in the future. 

What are the symptoms of a back strain?

Symptoms of back strain may range from a mild ache to sudden, debilitating pain often localized in the lower back. The pain of a back strain is likely to be located in the low back and not radiate down your leg (as with sciatica).

Your back may be sore to the touch, pain may come on suddenly, your lower back muscles may spasm, and standing or walking may be more uncomfortable than resting.

A summary of the potential symptoms caused by a back strain:

• Pain and demobilizing stiffness in the back
• Pain that spreads to the buttocks and the top of the legs, often in the back of the thigh 
• Pain that increases when a person bends over, stretches, coughs, or sneezes

What causes a back strain?

“How did this happen to me?” is likely the next question on your mind when you’re suffering from back pain.

Back strains are often the result of a movement or movements that put undue stress on the lower back. Motions like lifting a heavy object, lifting multiple heavy objects, lifting and twisting, a sudden and single twisting motion, or a fall are just some of the movements that can cause back strain.

Most lower back pain episodes are caused by damage to the muscles and/ or ligaments in the lower part of the back. When you suffer from back strain, you may have one or both of the following:

• A muscle strain is caused when a muscle is overstretched or torn, resulting in damage caused to the muscle fibers (also called a pulled muscle).
• A lumbar sprain is caused when ligaments – the tough fibrous tissues connecting the muscles to the bones and joints — are stretched too far or torn.

Strain and sprain are often used interchangeably, since the treatment and prognosis for both of these are the same. So, one is not worse than the other, although the amount of pain you’re experiencing may make you think that what you have is indeed the more severe of the two. 

Especially since you cannot see inside your back, your imagination may conclude that you have something much worse than a back strain or sprain. Patients experiencing pain can often jump to dramatic conclusions and envision difficult treatments ahead.

Fortunately, many simple treatments and lifestyle changes may help.

Lower Back Strain

A lower back strain is an injury that develops when a muscle that supports the lumbar vertebrae is stretched or torn. 

The muscles in the lower back are more susceptible to strains than the other regions of the spine. This is because the lower back supports the entire weight of the upper body. Additionally, the lumbar spine is more flexible than the middle or upper spine, contributing to your ability to bend, twist, and move. 

Regain your mobility with Premia Spine! Contact us now

You may be more likely to develop a lower back strain if you have a weak back, weak abdominal muscles, tight hamstrings, an extreme curve in the lower back, or a pelvis that naturally tilts forward. With this injury, many patients experience sudden pain in the lower back, along with lower back spasms. 

To protect your lower back against strains, focus on strengthening your core, practicing good posture, and avoiding heavy lifting. 

How can a back strain be treated?

With a mixture of painkillers and avoiding strenuous activities, many people can manage back pain and the sharp pain flare-ups that can make a back strain almost unbearable. 

However, you may still experience lower levels of pain, or pain flare-ups further down the line. This may last for weeks or even months, depending on how severe the strain was. 

To alleviate this pain, self-care is a must to help those stretched or torn muscles and ligaments heal fully. The average recovery time for a back strain is around three to four weeks, but this can vary depending on a person’s health, age, and general fitness level. 

To help speed up this recovery, we recommended the following at-home treatment:

• Use an ice pack on your back to ease pain and reduce swelling as soon as the strain occurs. You can do this for 20 to 30 minutes and repeat every 3 to 4 hours until the pain decreases.
• After 3 to 4 days, if you’re still experiencing pain, you may also use a heat pack or take a hot bath. This is only advised once the swelling has gone down. 
• Take non-steroidal anti-inflammatory painkillers, such as Advil, Aleve, or Motrin. However, it’s important to use these drugs sparingly, as there may be some side effects involved.
• Try physical therapy to stay active and regain strength in your back. This can maintain muscle tone and help build your abdominal and lower back muscles.
• Avoid bed rest and try to stick to a normal sleeping pattern. Lying or sitting down for long periods reduces blood circulation in your back, slowing the healing process.
• Do not turn down medical support, your doctor or physical therapist is a trained professional. Heed their advice, even if staying in bed seems like the easier option.

How to avoid back strains in the future?

There are several simple measures a person can take to help prevent back strains in the future. 

• Exercise your back muscles and stretch them regularly. Poor fitness and physical conditioning are some of the main causes of back strains.
• Although exercise is highly recommended, know your limits. If you’ve been exercising regularly, or stepping up your workout plan and suddenly feel pain in your back, then take a few days off and rest.
• If you feel any pain in your back during an activity, immediately stop. Do not try to persevere as this could stretch or tear the muscles or ligaments further.
• Focus on your sleeping positions and avoid lying on your stomach. If it helps, you can also place a pillow beneath your legs for support. 
• Always bend at the knees when lifting heavy objects.
• Maintain a healthy diet to try and keep your weight at a healthy level. 
• Focus on your posture and avoid slouching or hunching while working. 

We hope this article has helped to answer any questions you may have had about back strains and how to prevent such issues in the future.

Common Questions About Back Pain: What are the Different Types of Back Surgery

There are several different types of back surgery proving successful at resolving patients’ back pain issues, each involving the highest level of surgical technology available today, as well as the skill of a board-certified spinal surgeon. If your spinal specialist advises back surgery, you’ll embark upon a learning process about the different available back surgery procedures – guided by your physician. You always want to get your information directly from your spinal surgeon, since back surgery information online can be outdated or incorrect, and Googling back surgery topics can sometimes cause unnecessary anxiety.   The best course of action for researching back surgery procedures is to prepare a list of questions for your surgeon, and request all of the back surgery literature possible that your doctor can provide you with so that you can fully understand what will be done during your surgical procedure.

Overall, back surgery can accomplish several different pain-relieving goals, including removing portions of the bone to widen the narrowed area in your vertebrae, which can cause back pain. Your spinal surgeon may remove the gel-like middle section of a ruptured disc to relieve pressure on pinched nerves in the back. And sometimes, the damage to a disc is so severe, your doctor has to remove the entire disc and then fuse together the remaining discs.

Below is a list of some of the different types of back surgery that may be the customized choice for your back damage or condition:

• Discectomy. In this type of back surgery, your spinal surgeon will remove the herniated portion of a disc to relieve irritation and inflammation of a nerve.
• Laminectomy. This back surgery procedure involves removing the bone overlying the spinal canal, which then enlarges the spinal canal to relieve nerve pressure caused by spinal stenosis.
• Fusion. Spinal fusion permanently connects two or more bones in your spine. When the vertebrae are fused, you get added stability to your spinal movements, or relief of pain from a spinal fracture. Occasionally, spinal surgeons will opt for spinal fusion to eliminate painful motion between vertebrae that can result from a degenerated disc or injured disc.
• Vertebroplasty. During this type of back surgery, your surgeon will inject bone cement into compressed vertebrae to stabilize fractures or compressed vertebrae, which can relieve pain. A balloon-like method may be used to expand the vertebrae area, allowing your surgeon to inject the bone cement into the treatment area for optimal results.
• Artificial discs. Your spinal surgeon may find that your discs are in an advanced stage of degeneration, and that implanted artificial discs are necessary for the creation of a spine that functions better and without compression to the nerves. Artificial disc technology is advancing every day through rigorous studies and testing, and your surgeon can introduce you to the materials and information about having new discs implanted for your spinal pain relief.
• TOPS (Total Posterior Spine) System.  A mechanical implant device that stabilizes the spine without eliminating the independent motion of the individual vertebrae, as spinal fusion does.

Since back surgery is a complex procedure, work with your spinal surgeon to explore all your options.  Every situation is different and you need to feel secure that you have fully researched which type of back surgery would be best for you, and if back surgery is necessary at all. And of course, your doctor will guide you through all the information you need regarding recovering from back surgery and what you can expect for your post-surgery lifestyle.

reference: www.mayoclinic.com