Laminectomy is a surgical procedure in which just a portion or the whole backbone is removed. The backbone is known as the vertebra and the body of the vertebra is known as the lamina. Laminectomy is performed to relieve the symptoms of pain due to the compression of the spinal cord or nerves passing through the canal. Spinal cord compression and nerve irritation may be due to a variety of reasons like disc herniation, injury, narrowing of the canal in which the nerve passes through, or the presence of a tumor. Laminectomy surgical procedures are always performed when all the other treatment options are not suitable or do not give a response. The pain in the neck or lower back may range from mild to severe which can decrease the movement and function of these regions. Disc herniation is one of the most common causes of laminectomy. The disc can be displaced by some injury or trauma and irritate nerves when it is pressed on them. Irritation of nerves can create the symptoms of pain, numbness, and weakness. The pain can also be felt in the arms or legs. The most common discs are usually present in the lower back. To relieve these symptoms, laminectomy is often the only option to increase the movement and function that improves the overall quality of life of patients.
Types of Laminectomy Treatment in India
There are types of laminectomy according to the region of the spine treated or the extent of damage to the spine. These are:
- Medial Laminectomy
- Bilateral Laminectomy
- Laminotomy
- Lumbar Laminectomy
- Cervical Laminectomy
- Thoracic Laminectomy
In this laminectomy procedure, the inner part of the lamina is removed to create more space within the spinal canal and decrease the irritation of the nerves. This procedure is primarily used for severe spinal narrowing cases.
Bilateral Laminectomy
In this surgical procedure, both sides of the vertebrae that have their lamina are removed to decrease pressure on both sides of the spinal canal. This procedure is performed when the lamina irritates the nerves on both sides due to excess narrowing of the spinal canals.
Laminotomy
This is the less extensive procedure that involves removing only a small part of the lamina to relieve pressure on specific nerves. This procedure requires a more accurate target as compared to a full laminectomy.
Lumbar Laminectomy
The laminectomy procedure involves the removal of lamina in the lower back for issues like spinal stenosis or herniated discs that create pressure on the spinal nerves. This is the most common type of procedure performed.
Cervical Laminectomy
When the lamina in the neck region is involved, a cervical laminectomy surgical procedure is performed. Lamina is taken out to relieve symptoms like spinal cord compression that are caused by conditions like narrowing of the spinal canal in the neck region or disc herniation in the neck.
Thoracic Laminectomy
This is the less common type of laminectomy in which the lamina of the mid-back is involved. Thoracic laminectomy is performed to remove lamina that is creating spinal cord or nerve root compression issues.
Procedure of laminectomy
The general overview of the laminectomy procedure is:
- Anesthesia: The anesthesia is administered to make the patient unconscious and pain-free during the surgery.
- Incision: The surgeon makes an incision in the skin over the affected area of the spine. The length and location of the incision depend on the region of the spine.
- Exposure: The muscles and soft tissues around the spine are gently moved aside to expose the bony structures of the spine.
- Lamina Removal: The surgeon carefully removes part or all of the lamina, the bony covering of the spinal canal. This step creates more space and relieves pressure on the spinal cord or nerves.
- Decompression: Any structures, such as herniated discs, bone spurs, or tumors, that were compressing the nerves are identified and decompressed to relieve pressure.
- Closure: After completing the necessary decompression, the surgeon carefully closes the incision by using sutures. Sometimes, a drain may be placed at the surgical site to remove any excess fluids that might accumulate and create complications in the recovery process.
Cost of Laminectomy Treatment in India
The cost of laminectomy procedures in India ranges from ₹ 1,65,000 to ₹ 3,30,000. The cost can vary according to the condition of the patient at the time of operation or the complications during and after the surgical procedure. The cost can also vary in different cities of India.
- Lumbar Laminectomy for Spine : ₹ 1,65,000 - ₹ 2,20,000
- Spinal Laminectomy - ₹ 3,10,000 : ₹ 4,10,000
Symptoms & Risk Factors of Laminectomy Treatment in India
Some of the conditions or diseases in which the laminectomy is indicated are:
- Spinal stenosis
- Herniated disc
- Degenerative disc disease
- Foraminal stenosis
- Disc protrusion
- Sciatica
- Spinal tumors that depend on the location and extent
- Bone spurs causing nerve compression
- Recurrent disc herniation
- Spinal infections or abscesses
- Traumatic spinal cord or nerve injury
- Spinal cysts or synovial cysts
- Spondylolisthesis
- Spinal deformities causing nerve compression
- Failed previous conservative treatments for spinal conditions
- Cauda equina syndrome is a severe condition requiring urgent surgical intervention
- Lumbar discogenic pain is chronic lower back pain caused by degenerated discs
- Vertebral fractures in specific cases with nerve impingement
- Intractable radicular pain
Risk factors of Laminectomy Treatment
Some of the risk factors of laminectomy are:
Infection
There is a risk of developing an infection at any open surgery. So the proper medications to prevent infection are essential part.
Bleeding
There is a risk of excessive bleeding or hematoma formation. In rare cases, blood loss is so extensive that there may require blood transfusions.
Nerve injury
The cervical spine contains important nerves and there is a risk of nerve injury that can lead to weakness, numbness, pain, or even paralysis. The pain and other symptoms are according to the region involved.
Spinal instability
Removing a significant portion of the lamina can compromise spinal stability, possibly necessitating additional surgical interventions such as spinal fusion.
Postoperative scar tissue can sometimes form around nerves, causing pain or nerve irritation.
Failed back surgery syndrome
In some cases, despite the surgery's success, the original symptoms may persist or return due to various factors.
Pain and discomfort
After cervical spine surgery, it is common to experience pain and discomfort. This can be managed with painkillers.
Anesthesia risks
The use of anesthesia carries certain risks, such as allergic reactions, breathing problems, or adverse effects on the heart.
Blood clots
Surgery increases the risk of developing blood clots in the legs or lungs. Proper care is required otherwise it can also lead to death.
Segment degeneration
After laminectomy surgery, stress on surrounding spinal segments can increase, which can lead to overuse injury or tear, known as segment degeneration. This can cause new symptoms and may need new surgery to manage the problem.
