Laminectomy

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Laminectomy is a surgical procedure that removes some of the vertebral bone called lamina. The back muscles are removed rather than cut and the parts of the vertebrae adjacent to the lamina are left intact. Recovery usually occurs within a few days.

Video Laminectomy

Metode

Lamina is the posterior arch of the vertebral bone that lies between the spinous processes (which stand out in the center) and the more lateral pedicles and transverse processes of each vertebra. A pair of laminae, along with the spinous process, form the posterior wall of the spinal canal of the bone. Although the literal meaning of laminectomy is 'lamina excision', a conventional laminectomy in neurosurgery and orthopedics involves excision of the posterior spinal ligament and some or all of the spinous processes. The removal of this structure by an open technique requires the disconnection of many back muscles attached to it. The laminectomy performed as a minimal spinal procedure is a tissue preservation operation that leaves more muscle intact and saves the spinal process. Another procedure, called laminotomy, is the removal of the middle portion of one lamina and can be performed either by conventional open technique or by a minimalist manner using a tubular retractor and an endoscope.

A lamina is rarely, if ever, removed because the lamina itself is sick. In contrast, the removal is done to break the continuity of the rigid ring of the spinal canal to allow soft tissue within the canal to: 1) expand (decompress); 2) change vertical column contour; or 3) allow access to deeper tissues within the spinal canal. Laminectomy is also the name of a spinal surgery that conventionally includes removal of one or both laminae, as well as other posterior supporting structures of the vertebral column, including ligaments and additional bone. Actual bone removal can be performed with a variety of surgical instruments, including exercise, rongeurs and lasers.

The success rate of the laminectomy depends on the specific reason for the surgery, as well as the proper selection of patients and the technical abilities of the surgeon. The first lectectomy was performed in 1887 by Victor Alexander Haden Horsley, a professor of surgery at University College London. A laminectomy can treat severe spinal stenosis by reducing the pressure on the spinal cord or nerve root, providing access to tumors or other mass located in or around the spinal cord, or assisting in adjusting vertebral column contours to improve spine deformity such as as kyphosis. This type of laminectomy is commonly done to allow the removal or re-establishment of the spinal disk as part of the lumbar discectomy. This is the treatment for disc herniation, prominence, or degeneration.

The recovery period after laminectomy depends on specific surgical techniques, with minimally invasive procedures that have shorter recovery periods than open surgery. Removal of large amounts of bone and tissue may require additional procedures such as spinal fusion to stabilize the spine and generally require a much longer recovery period than simple laminectomy.

With spinal fusion, recovery time may be longer. In some cases after laminectomy and spinal fusion, it may take several months to return to normal activity. Potential complications include bleeding, infection, blood clotting, nerve injury, and spinal fluid leak.

Maps Laminectomy

For spinal stenosis

Most commonly, a laminectomy is performed to treat spinal stenosis. Spinal stenosis is the most common single diagnosis leading to spinal surgery, in which laminectomy is a component. Lamina vertebrae are removed or trimmed to widen the spinal canal and create more space for the spinal cord and thecal sac. Surgical treatments that include laminectomy are the most effective drugs for severe spinal stenosis; However, most cases of spinal stenosis are not severe enough to require surgery. When symptoms paralyze spinal stenosis mainly neurogenic claudication and laminectomy performed without spinal fusion, there is generally rapid recovery and long-term relief. However, if the spinal column is unstable and fusion is required, the recovery period may last from several months to over a year, and the possibility of relieving the symptoms is much less likely.

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Results

In most cases of known lamination and thoracic, patients tend to recover slowly, with recurrent pain or spinal stenosis persisting up to 18 months after the procedure. According to the World Health Organization census in 2001, most patients who had undergone lumbar laminectomy restored normal function within one year of their operation.

Back surgery can reduce the pressure on the spine, but this is not a cure for spinal stenosis. There may be considerable pain soon after surgery, and the pain can persist on a long-term basis. For some, recovery may take weeks or months and may require long-term occupational and physical therapy. Surgery does not stop the degenerative process and symptoms may reappear within a few years.

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See also

• Artificial faceted replacement
• Failed back syndrome
• Spinal stenosis

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References

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External links

• Laminectomy
• Operation Back: When It's a Good Idea
• Laminectomy - Information for Patient Site is no longer available
• Laminectomy - Better Health Line
• Explanations and illustrations of minimal spinal laminectomy operations

Source of the article : Wikipedia