Laminectomy in Iran

How Laminectomy is Performed?

Laminectomy involves cutting off the lamina which is part of the bone (vertebrae) that makes up the spine. The procedure can help take the pressure off the spinal cord and nerves. By removing the compression, the procedure can improve pain and other symptoms relating to herniated spinal disc, arthritis in the spine or spinal stenosis. 

Laminectomy surgery can be performed within 1 to 4 hours. It includes 5 major steps:

1. An anesthesiologist will put you under general anesthesia.
2. As you are positioned on your side or with your abdomen on the operating table, the medical team will begin monitoring your vital signs like breathing, heart rate, and blood pressure.
3. After making sure the surgical area is hairless and cleansed, the surgeon will make an incision which could be between 2 to 4 inches long depending on the number of laminas that need to be removed.
4. Once the spinal bones are revealed, the surgeon can remove the bone spurs that are causing the tension. Sometimes, this step ends with spinal fusion to connect two bones.
5. When everything is all set, the surgeon closes the incision using sutures or surgical staples.

Laparoscopic laminectomy or minimally invasive laminectomy

Laminectomy is commonly operated as an open-back surgery but some patients can benefit from minimally invasive laminectomy surgery which is performed laparoscopically using a microscopic camera and small surgical tools. During this technique, only small one-inch long incisions are made. Laparoscopic lumbar laminectomy has two main advantages. The procedure involves making small incisions that aren't lengthier than an inch leading to almost indiscernible scars. Besides, it does not require a long recovery period; in most cases, the patient can start walking immediately after the surgery.

Laminectomy and Spinal Fusion

When multiple laminas are removed, your doctor may decide to perform spinal fusion after laminectomy; this is to secure the stability of the spine. The operation takes place by joining two vertebrae using a bone graft. The bone graft is usually grafted from the top of your hip. Hardware such as plates, screws, hooks or rods can also be utilized during spinal fusion. Performing spinal fusion in conjunction with laminectomy can increase the time to recover after the procedure. 

The difference between a laminectomy and a laminotomy

While laminectomy can relieve the pressure on the nerves by removing the entire lamina, laminotomy can do so less invasively and without making large incisions. During a laminotomy, the surgeon makes a couple of small openings on the lamina to reduce compression. This minimally invasive procedure gets rid of the painful symptoms while leaving the spinal stability intact. Therefore, performing spinal fusion is rarely needed after a laminotomy. 

Laminectomy or Discectomy

Discs are positioned throughout the spine acting as shock absorbers between the spinal bones (the vertebrae). Bulging discs can cause damage to the nerves. Discectomy is a procedure to remove the bulging or herniated disc. Both laminectomy and discectomy aim at making extra space around the nerve root to reduce the compression. However, while laminectomy removes most or all of the lamina (a part of the vertebrae), discectomy cuts off the disc that is in between two individual vertebrae. 

When is laminectomy needed?

Candidates of laminectomy might experience severe pain in the back, shoulder, arms, and legs. The pain can even be accompanied by weakness or numbness that gets worse in the limbs or arms. When the symptoms do not improve with physiotherapy or medications such as steroid injections and anti-inflammatories, the orthopedist or neurologist might suggest laminectomy surgery. The compression of nerves can be caused by certain conditions: 

• Herniated disc: A herniated or slipped disc can happen as a result of a ruptured disc. It is one of the most common causes of back and leg pain and can be followed by painful symptoms or no symptoms at all. Some people do not need to undergo surgery to fix the issue. But for others, surgery can be beneficial when all other options fail.
• Spinal stenosis: This condition occurs as a result of narrowing of the discs within the spine. The rubbery cushion between the vertebrae can degenerate over time due to age or injuries. Spinal stenosis can happen with or without showing symptoms of pain, numbness, and weakness.But it can successfully be treated with laminectomy.
• Spinal arthritis: Arthritis in the neck and back refers to the inflammation of the joints. It can cause severe pain and discomfort in the area that could become chronic. Genetics and age have been identified in connection with the condition. When the symptoms indicate nerve damage, laminectomy will be suggested as an effective surgical treatment.

In order to find out whether you need the laminectomy surgery, you can contact our healthcare professionals sending them the results of diagnostic tests such as MRI, CT or myelogram. They will reach out to you and provide you with the best possible solution. Through our platform, you can consult with experts for free.

What is Laminectomy Success Rate?

An exact success rate cannot be stated because it could vary based on the reason behind the surgery, the technical method used, and the patient's age and health condition. A rough figure can be interpreted from a study conducted by the University of Wisconsin. According to the study, the majority of laminectomy patients reported that the pain was minimalized to great extents. 

Why Laminectomy in Iran?

Because Iran is a hidden gem among all medical tourism destinations. According to the head of the Iranian Orthopedic Surgeons Association, Iran can offer quality orthopedic surgeries with the same success rate as countries such as the US, UK, France, Japan, and Germany. Add this to the fact that Iran is ranked as one of the top 10 countries for orthopedic surgeries. This has been the leading reason why people from different nations select Iran for their riskiest procedures.

As much as Iran is among the top 10 countries for orthopedic surgeries, it is not included in the list of most expensive ones. That is, you can receive high-quality medical service which is at par with that of pioneer countries at a price that is about 60% less. 

How to Prepare for Laminectomy?

Like all surgeries, laminectomy requires being attentive to pre-op instructions suggested by your doctor. Basically, most surgeons will recommend the following tips:

• Avoid certain medications such as anti-inflammatory weeks before the surgery. Some medications can increase bleeding and hinder healing after surgery.
• Stop eating or drinking anything including water around midnight before the surgery.
• Take a shower in the morning before the surgery. Do not apply any lotion or perfume on your back.
• You can ask one of your friends and family to accompany you during the journey. You can use their help.

Laminectomy Recovery

After the surgery, expect to spend 4 to 5 days in the hospital. You can gradually increase your activity level starting from day one. If spinal fusion has been performed, you might have to wear a brace for about 25 days. 

Pain is normal

You might feel some pain. Certain measures are taken to ensure the pain is as minimal as possible. You might be prescribed pain medications or recommended to use ice compresses on the surgical area three or four times a day.

A change in daily habits

The first two weeks are crucial. During this period, you should avoid activities that involve bending, lifting or twisting. Driving is prohibited unless your surgeon advises you otherwise. Smoking and drinking alcohol should also be avoided. You might feel pain while doing some basic daily activities, stop whenever you felt uncomfortable. You can ask a friend to help you with bathing or getting dressed.

Caring for the incision

You should make sure the incision on your spine is clean and dry the whole time you are recovering. Ask your surgeon when and how you should take a shower with the incision still healing. Avoid soaking the incision by bathing or swimming in pools. Do not put any kind of lotion on your back. You might see a mild amount of drainage coming out of your incision. Contact your healthcare follow-up team if drainage was in large amounts or strange in color. After the 2-week period, you can visit your surgeon to remove your stitches.

Normally, you can leave Iran in 2 to 3 weeks. As the most reliable source, your surgeon will tell you about the exact amount of days you should wait before getting on the plane. Flights can lead to blood clots forming in your legs. Thus, it is important to do as your doctor suggests.

Concerning activities

After most orthopedic surgeries, there will be some physical restrictions; a laminectomy is no exception. Almost all activities involve engaging our torso. Therefore, it is vital to pay more attention to your every movement after a laminectomy. In case you used to pursue a particular sport, you have to stop the exercises for at least three months after the surgery. 

Laminectomy recovery exercises

This doesn't mean you have to lie down on a bed during recovery. To help your bones and muscles regain their strength, you have to perform some recovery exercises. Immediately after the procedure, a physical therapist will come by to help you with the movements. This phase is known as low back rehab. 

After the rehab sessions are over, you will have to focus more on maintaining a good posture and sticking to routine exercises that can prevent back pain in the future. 

First and foremost, you can experience the optimal laminectomy outcome by walking on a daily basis. Walking is an excellent exercise to strengthen your back muscles and improve blood circulation. It can also help you get used to the straight posture. Another way to maintain a healthy spinal position is by sitting in the proper way; with your hips on the far end of your seat and your spine stable and straight.

Aside from walking and maintaining a posture suitable for your delicate situation, you can also benefit from certain exercises:

• The prone press ups: after the surgery, you should focus on protecting your discs. This exercise is a great way to strengthen your lumbar discs after a laminectomy. Begin by lying on your stomach with your face down. Put your palms on the mat and under your shoulders. Pushing your hands and arms down to the mat, try to lift your torso as much as you can with your limbs still on the floor. You can feel the pressure on your lower back. Hold the position for two deep breaths and then slowly lower your trunk. Repeat for 10 times.
• Supine lumbar flexion: this exercise can effectively stretch your back muscles. It is also a very easy and relaxing move. First, you need to lie on your back with bent knees. Then, gently lift your knees and bring them closer to your chest using your hands. Relax your back and let your shoulders stay on the mat. Hold onto this posture for a deep breath and then slowly let go of your knees. Repeat the exercise 10 times. Let the pain be your guide and stop when you felt sharp pain.
• Prone straight leg raise: strong back muscles can ensure that your new spinal bone will be sufficiently protected and stabilized. This exercise is a great way to strengthen your muscles and improve spinal stability. To perform it, lay on your back and slowly lift one leg and hold it up for two or three deep breaths. Then, gently lower it to the starting position. Repeat with the other leg. You can do this exercise 10 or 15 times a day.

FAQ 

Can laminectomy be done twice? 

Yes. Repeat laminectomy is possible for patients who do not observe pain relief after the first procedure.

Can laminectomy regrow?

After laminectomy, the bone can grow back again causing compression on the nerves root. 

How long after laminectomy can you exercise?

You cannot engage in strenuous exercises that involve bending or lifting heavy things for at least 3 months after the surgery. However, you can start the physical therapy exercises or short distance walking as soon as your doctor suggests. 

Can a laminectomy cause paralysis?

As with any major surgery, a laminectomy can be followed by possible complications. One of the least likely risks of back surgery is paralysis.