Open Microlumbar Laminectomy
& Discectomy
What is it?
Open microlumbar laminotomy/discectomy
is an operation performed on the lower spine to relieve pressure
on one or more nerve roots. The operation is usually performed
under general anesthesia or a spinal anesthetic. Frequently
it is performed as an inpatient but if the patient is stoic and
doctor agrees it can be performed as an outpatient procedure.
A catheter may be placed in your bladder if the surgery is planned
to take a long time.
Why Is It Done?
When an intervertebral
disc ruptures in the lumbar spine, it puts pressure on one or
more nerve roots (often called nerve root compression). This causes
pain and other symptoms in the neck, arms, and even legs. In this
operation, the surgeon reaches the lumbar spine through a small
incision in the low back. After the muscles of the spine are stripped
from the vertebral bone the nerve root is exposed by removing
part of the bony covering (lamina), which covers the nerve root.
This is called a laminotomy. Usually as much as possibe of the
abnormal intervertebral disc is then removed taking the pressure
off of the nerve root. Since the spinal canal is opened
the may be post-operative scar formation which can cause delayed
recurrent nerve pain. Since much of the nuclear material
is removed from the center of the disc, delayed vertical instability
with disc space collapse frequently will occur.
What Happens Afterwards?
At home you will have
to take narcotic medication to help with any discomfort. Any severe
increase in pain not controlled with the medication should also
be reported to your physician or the physician's nurse. You should
report any elevation in your temperature, drainage from you incision,
or increase in numbness or weakness.
Successful recovery
from an open lumbar laminotomy/discectomy requires that you approach
the operation and recovery period with confidence based on a thorough
understanding of the indications, alternatives, and risks of your
procedure. The better informed you are the better prepared you
will be for the post operative period. Do not hesitate to ask
questions and be certain that you clearly understand the answers.
Your body will work to heal the involved muscle, nerve, and bone
tissues but since muscle is stripped and bone removed it takes
months for the deep scar healing. Full recovery, however,
will also depend on you having a strong, positive attitude, setting
small goals for improvement, and working steadily to accomplish
each goal.