Laminectomy

Hiya China.

Taking your 2nd point 1st China, the way Medics describe and name procedures are purposely vague and confusing. They don't want the likes of you and I knowing too much detail about whats going to happen to us 'or' how poor the probable clinical outcome will be! If they make a mess, we will be none the wiser!!

I don't know whether you were told the same as me, I know a lot of people have been, but when I consulted a Spine Surgeon about a laminectomy, he told me that I would probably have the same levels of pain after the operation and would possibly experience even worse pain levels after the operation!! He said, that as I was very fit for my age, the procedure was, too destructive, could make things worse and he did not want to carry out the procedure on me!

You see China, the 'Laminectomy' and 'discectomy' are different things,
so you will probably be having both, it all depends on the start point of the disccussion. Laminectomy, describes 'the procedure that gains the access' to the area that the Surgeon wishes to operate on, in your spine system. There are two main types of laminectomy;

Open back
and
Minimally invasive

Open back laminectomy, involves a 4 or (up to) 6 inch initial incision.
Surgeons then cut down towards the 'working' area, in this process they cut and disect 4 - 6 inches of, skin, tissue, nerves, muscle, vertibral lamina, spinal ligaments and disc tendons. If a muscle is attached to a part of the 'vertibral lamina' that needs to be removed in order to gain access to the working area, the Surgeon will 'detach' the muscle tendon that attaches it to the lamina and try to re-attach it after the opertaion! These areas are damaged in this way, before Surgeons carry out any repairs or improvements to decompress the nerve strands.

The Surgeons then look in to the working area from the outside of the body using microscopes and/or x-ray visualiseation equiptment like flouroscopes.

Once this has been achieved, the Surgeons can carry out a variety of decomression procedures, such as, nerve root decompression, osteophyte removal, vertibral fusion and of course discectomy.

Standard minimally invasive laminectomy, and its destruction, is exactly the same as the 'open back' one above,
except that the initial incision is usually only 2 - 3 inches long and whilst it damages the same things, nerves, tissue and muscle etc, this version 'initially' damages a smaller area of all of those things.
However, what happens next, does increase the damage area and types of things damaged. In this procedure, Having made the incision, the Surgeon inserts a 'large retractor' in to the hole in the back, in order to open up the incision site, this is so that the 'final working area' is about the same size as that of the open back laminectomy. This stretching process can and does cause additional tearing, brusing and crushing damage!

All of these damaged areas then have to heal after the operation, and it is this that which causes a lot of the post operative complications, even if the discectomy was a success! This is why most patients complain of post op pains and problems, they don't always heal properly!! This is why the chances of a full clinical recovery from standard spinal surgery is poor and has a long rehab time scale.

Discectomy, is the process of clearing leaking nucleus debris, bulging anulus and tethering nerves and as much as possible reduce the extent of the bulging and impingements.

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China, are your transferred leg pains traveling down the front or the back of your left leg?

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Get your Consultant to explain everything about the procedure (in detail)
including,
what the Safety rates are for this procedure?
what the Effecivness rates are for this procedure?
What will the incision size be?
How long before you can drive?
What help can you get with post operative core stability execises?
How long will you be in hospital?
What level will he be operating on?

He won't want to tell you these things, and he won't like having to, but you must get him to explain so that you know what you are getting yourself in to!!

All the very best.

SPINELF

Hello Spinelf

Thank you so much for replying to my post.:)

I've jotted down your questions and I shall be taking them with me tomorrow. Really helpful.

Getting so nervous about tomorrow even though this is only the pre-op. Goodness knows what I will be like on Monday.

Understandable China!

We are all preconditioned to accept what the Surgeons tell us as being true and accurate, this how ever, is rarely the case.

Be strong and ask the questions, write down the answers and reveiw them at your leisure.

Very best wishes for a good and informative consultation.

SPINELF

Is there much difference between a discectomy and a laminectomy?

Yes,
I had both done at the same time in an open back surgery 6 weeks ago.

The lamina is the bone that surrounds the spine which houses the nerves.
By removing a piece of it (laminactomy) the pressure on the nerves lessen and the inflimation caused by the pressure can be healed.

The Discectomy is the removal of the raptured disc to ensure that it will not cause the same problems again in the future.

Hiya China.

Hello Spinelf

Thank you so much for replying to my post.:)

I've jotted down your questions and I shall be taking them with me tomorrow. Really helpful.

Getting so nervous about tomorrow even though this is only the pre-op. Goodness knows what I will be like on Monday.

How are you getting on China?, how was the Consultation?

How are you getting on China?, how was the Consultation?

Well I'm now 9 days post op and due to see practice nurse tomorrow to have stitches taken out.

I was in theatre for 5 hours so it took longer than was expected. Stayed in hospital for 5 days. My only real concern is the lack of feeling in my right leg. Consultant said that it could take 6 to 12 months to get full feeling back due to nerve damage. Hence, having to use crutches to get around. Yesterday and today, I feel like I have been kicked in the back by a horse. Must be the bruising coming out I presume. Goodness only knows when I will be able to drive again.

Hubby has been with me at home this week but I'll have to manage on my own next week.

Hope everybody else is doing ok.

Take care

Physio?

Does anybody have any ideas about leg numbness post op. Op was 3 weeks ago today.

Also, one of my friends asked when I was starting physio. I told her that nothing has been mentioned about any follow ups or exercises. When I left hospital they told me that I woud get an appointment for 6 weeks post op to check all was ok. Well, the letter came and it is actually 12 weeks. Apparently that is the earliest they can see me.

I just feel a little bit left out on a limb really. Still using crutches to get about as I can't feel the majority of my right leg.:(

Spineself

have suffered with back pain for some 5 years now,i am 30 now, i have had episodes where it has been really bad, sort of gone and been bearable. Last November it starting getting really bad and has only got worse, i havnt really done any sport since.I had another mri confirming the disc bulge on my nerve.. I have done the physio thing, had the nerve block injection which only helped for a short time.. It is now bad again, i cannot straighten up properly and am bent forward when walking, as this causes the pain, seem in both legs the mo. I dont walk i shuffle! when i turn over in bed! the pain is bad!
I went to see the orthopedic spinal surgeon at bupa cardiff, he has recommended L4/L5 decompression, which is booked for the 12/3/09.

I dont really want to go under the knife, but i have gone from being active, surfing mountain biking, to doing absolutely nothing!!!

Is this the only route?

Spineself
Is this the only route?

Yes Smitho, In Wales, its all they will offer you. Success with your decopression procedure will depend on the dilligence and humanity of your Surgeon. I made 2 'freedom of information' requests to the spine unit in Cardiff, most of the BUPA Spine Surgeons are also NHS Spine Surgeons, and they informed me that they did not 'record or keep' records of how safe or successful their procedures are!!

If you have private health insurence then check out;
<a class="go2wpf-bbcode" rel="nofollow" target="_blank" href="www.spinal-foundation.org">www.spinal-foundation.org
To cross referrence, have a look at the following sites showing the 'future' of spinal surgery being carried out 'today' in the USA.
<a class="go2wpf-bbcode" rel="nofollow" target="_blank" href="www.bonati.com">www.bonati.com
<a class="go2wpf-bbcode" rel="nofollow" target="_blank" href="www.laserspineinstitute.com">www.laserspineinstitute.com
<a class="go2wpf-bbcode" rel="nofollow" target="_blank" href="www.microspine.com">www.microspine.com
<a class="go2wpf-bbcode" rel="nofollow" target="_blank" href="www.zerospinepain.com">www.zerospinepain.com
<a class="go2wpf-bbcode" rel="nofollow" target="_blank" href="www.www.sdspineinstitute.com">www.www.sdspineinstitute.com
<a class="go2wpf-bbcode" rel="nofollow" target="_blank" href="www.spinecenter.com">www.spinecenter.com
Also view, for research purposes;
<a class="go2wpf-bbcode" rel="nofollow" target="_blank" href="www.spineuniverse.com">www.spineuniverse.com
<a class="go2wpf-bbcode" rel="nofollow" target="_blank" href="www.back.com">www.back.com
<a class="go2wpf-bbcode" rel="nofollow" target="_blank" href="www.chirogeek.com">www.chirogeek.com
<a class="go2wpf-bbcode" rel="nofollow" target="_blank" href="www.spine-health.com">www.spine-health.com

If you decide to go through with the decompression Smitho, Here's wishing you all the very best and here's hoping for a speedy and successful recovery!!

Best wishes

SPINELF

Hiya china!

I just feel a little bit left out on a limb really. Still using crutches to get about as I can't feel the majority of my right leg.:(

I am so sorry to that you feel abandoned me old China. Go and see your GP and 'demand' to be referred to a physiotherapist right now!!
The biggest part of a successful recovery from spine surgery, is the period of post operative rehabilitation and core stability exercises, these should have started from day one, post op!

The numbness in your legs may improve with time and exercise, but until you have been given monitered exercises to carry out over the coming months, you will have no way of knowing, until its too late!

Go and see your GP now!!

All the very best of luck.

SPINELF

No follow up!

Recovery following the op has been so much slower than I was expecting. I am now 8 weeks post op and can walk around without crutches but need to keep walking down to about an hour or so at a time as I get sore and very tired.

My post op appointment will be 12 weeks since surgery. Apparently they are very busy and can't see me as promised at 6 weeks post op.:confused:

I was hoping to go back to work at the end of March but due to lack of blood tests following the op, my gp did full blood count which resulted in my haemoglobin level result being 2.5. Should be 11 for a a woman.:eek:

Asked about exercises and she just said to maintain steady walking. Should be back at work at the end of April if my blood is better.

One thing I would love the answer to is the numbness I still experience in the leg I use to have the pain in. It is numb from my buttock, down my thigh, into my calf and the whole of my foot. Just want to know if this is normal. I am sure it is, but would just like some reassurance.

Hiya China

Hi China.

I really don't want to panic China, but with regards to your concerns about the continuing pains and numbness in your legs and buttocks, it could still just be post op mending, but if it continues 'or' does not improve significantly in the next 2-3 weeks, you should demand a re-assesment by your Surgeon.

The bottom line is this, if the laminectomy and other decompression work that the Surgeon did on you was successful, you should have gained some significant improvement by now, because once the mechanical contact between the nerves and the impinging bones or discs have been removed, there should be some immediate relief, because the reason for the pain has been removed!!

If things do not improve soon, there could be justifiable concerns regarding nerve damage, scarring, procedure failier or the wrong area having been operated on.

Don't leave it too long to act, I did, and it's now been nearly 6 years!!
Be warned!!

Best of luck with your bloods China, and kind regards and best wishes.

SPINELF

Hello China

My left thigh just above the knee has been numb for 24 years, that is when I got my 1st Spinal surgery.

I simply got used to it and it never really bothered me, suppose I was just happy that I had no pain.

Unfortunately all went to pot last year and I really bad backache and muscles spasms, pains, tingling and numbness down my left leg.

Went under the knife on the 22nd November and I have been terrible ever since, with terrible pain right across my lower back, ended up back in hospital for 13 days and couldn't even get out of bed. They eventually got me mobilsed using a zimmer frame after 10 days.

I have been doing pyhsio everyday but still in bad pain and the muscle spasms are very very painful, I'm in agony just trying to turn over in bed.

Also every now and again, maybe up to 10 times a day, I get what can only be described as an electric shock right across my lower back if I move in certain ways.

I would never ever reccommend anyone to have spinal surgery unless their life depended on it. I'd explore absolutely every conceivable means before going under the knife.

I have an absolutely miserable life and this is me much better than I was a few weeks ago.