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Microdiscectomy -is one of the most minimally invasive procedures performed for leg pain (scaiatica ) from lumbar herniated disc. In this surgery, with a relatively small incision the portion of the herniation that is in contact with the nerve root is pulled out.
Lumbar laminectomy (open decompression)-is performed for pain from lumbar spinal stenosis. During this procedure, the lamina (the bone in the back of the vertebra) at one or more segments is removed with the goal of reducing pressure on the spinal cord or nerves
Corpectomy – mostly used in cases of cervical surgery , it involves removing part of the vertebra in order to decompress, or relieve pressure on spinal nerves.
Laminotomy - this surgery is essentially the same as a laminectomy, with the exception that a hole is made in the lamina and removal of a small portion of the lamina and ligaments, usually on one side so the natural support of the lamina is left in place, decreasing the chance of postoperative spinal instability.
Foraminotomy is the removal of bone around the neural foramen to release the pinched nerve . This method is used when due to disc degeneration the height of the foramen has collapsed.
significant pain, weakness, or numbness in leg , neurological symptoms not improved with physiotherapy or medication
difficulty walking or standing that affects quality of life
diagnostic tests like MRI , CT , Myelogram confirming severity of condition
Pre-operative Assessment
General health check to ascertain fitness for surgery, past medical , surgical history .
Blood tests
X-ray , MRI scan
Anaesthesia -procedure performed under general anaesthesia .
Incision- A skin incision is made down the middle of your back over the appropriate vertebrae, The length of the incision depends on how many laminectomies are to be performed.
The strong back muscles are split down the middle and moved to either side exposing the lamina of each vertebrae.
laminectomy or laminotomy- Once the bone is exposed, an X-ray is taken to verify the correct vertebra, the lamina at one or more segments is removed.
Decompress of the spinal nerve
Closure- The muscle and skin incisions are sewn together with sutures or staples.
The length of stay in hospital depends on the degree of decompression performed usually the surgery requires a hospital stay from 1 to 3 days and recovery takes between 4 to 6 weeks.
Stitches or staples will be removed 10 - 14 days after your operation
Avoid sitting for long periods of time.
Do not lift anything heavier than 10 pounds ,
Do not bend or twist at the waist.
Do not smoke. Smoking delays healing
As in any surgery there can be complications:
Pain
Bleeding,
chances of blood clots (DVT)
Infection
Continued pain or numbness
Loss of bladder or bowel control
Infection in the spine
Nerve damage Nerve damage or persistent pain. Any operation on the spine comes with the risk of damaging the nerves or spinal cord. Damage can cause numbness or even paralysis.
Leaking of spinal fluid
The cost to the patient depends on a variety of factors like
The hospital, the patient chooses.
Room –Standard single room, deluxe room, super deluxe room for the number of nights specified (including nursing fee, meals, room rate, and room service).
Fee for the team of doctors and OT charges
cost of medications
Standard test and diagnostic procedures.
Cost of the follow –up care required after the procedure
Physiotherapist cost
Spine Decompression - Overview - 6.5 Minutes Video