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You have a “pinched nerve.” This can be produced by one or more herniated discs and/or areas of arthritis in your back. The discs are rubbery shock absorbers between the vertebrae, and are close to nerves that originate in the spine and then travel down to the legs. If the disc is damaged, part of it may bulge (herniate) or even burst free into the spinal canal, putting pressure on the nerve and causing leg pain, numbness or weakness. Bone spurs associated with arthritis may do the same thing.
The discs or bone spurs pressing on your nerve must be removed. This is done by making an incision (usually two or three inches long) in the middle of your lower back, moving the muscles covering your spine to the side, and making a small window into your spinal canal. The nerve is exposed, moved aside and protected; and the protruding disc or bone spur is then removed. This decompresses the nerve and, in most cases, leads to rapid improvement in nerve pain, numbness and/or weakness. Sometimes the abnormality may be more extensive, extending over several disc segments, requiring a longer incision for decompression.
The primary reason for this operation is pain that is intolerable to the patient.
Sometimes increasing nerve dysfunction (particularly weakness) or loss of bowel or bladder control may make the surgery necessary even if pain is not severe. In most cases, nerve dysfunction is not severe and pain can be controlled by non-surgical means. You may be referred to physical therapy. You can schedule an appointment with our outpatient Physical Therapy by calling 732.557.3283. If the pain and subsequent disability become intolerable, surgery is a reliable way to solve the problem. Since the patient is the one feeling the pain, the patient is usually the one who decides when he or she is ready for surgery.
Both orthopedists and neurosurgeons are trained in spinal surgery and both specialists may perform this surgery. It is important that your surgeon specialize in this type of procedure.
No, only the ruptured part and any other obviously abnormal disc material is removed. This generally amounts to no more than 10-15 percent of the entire disc.
Laminectomy patients are usually out of bed within an hour or two after their operation, and some can go home on the day of surgery and others almost always go home the next morning.
Transfusions are rarely needed after this kind of surgery. We do not recommend preoperative donation of your own blood.
You may get up and move around as soon as you feel like it, and may drive short distances when you feel able. You should avoid bending, lifting and twisting for six weeks to allow for healing of the surgical area.
That depends on the kind of work you do, and how long you must travel. Surgical patients can return to sedentary (desk) jobs that they can reach with a drive of 15 minutes or less whenever they feel comfortable, (usually two or three weeks).
You should not drive long distances (30 minutes or more) for about one month after surgery. If your job requires physical labor, you should consult your surgeon.
90-95 percent of patients get relief of their leg pain. Some patients (about 15 percent) will continue to have noticeable back pain in some situations, and may require additional treatment.
The chances of neurologic injury with spine surgery are very low, and the possibility of catastrophic injury such as paralysis, impotence or loss of bowel or bladder control are highly unlikely. Injury to a nerve root with isolated numbness and/or weakness in
the leg is possible.
There are general risks with any type of surgery. These include, but are not limited to, the possibility of wound infection, uncontrollable bleeding, collections of blood clots in the wound or in the veins of the leg, abdominal problems, pulmonary embolism (a blood clot to the lungs) or heart attack. The chances of any of these happening, particularly to a healthy patient, are low. Rarely, death may occur during or after any surgical procedure.
Though you may have excellent relief of pain, a disc is never completely normal after it has herniated, and if your problem has been caused by arthritis, the arthritis cannot be cured even if the bone spurs have been removed and the nerves decompressed. You may have more back pain than a normal person would have, and there is an increased risk of re-herniation of the damaged disc. However, most people can resume almost all of their normal activities after recovering from surgery.
You should resume low-impact activities as soon as possible, starting with walking.
Try to walk a little farther each day, building up to a brisk three-mile walk each day by six weeks after surgery. Once your sutures are removed you may swim, which is very back friendly. By two or three weeks after surgery you may try more vigorous activities such as an exercise bike or NordicTrack. Talk to your surgeon about aerobics and jogging. Physical activity is good for you, if done properly.
In general, you should limit heavy lifting, bending, twisting and high impact physical activities, including contact sports. Consult your surgeon for details.
Unfortunately, yes. As mentioned above, only part of the disc is removed and there is no way to make the disc normal again, so recurrent herniations do occasionally occur.
Also, adjacent discs may be abnormal, too, and could rupture in the future.
No. Exercise is good for you! You should get some sort of moderate, low-impact aerobic exercise at least three times a week. Walking either outside or on a treadmill, using an exercise bike and swimming are all examples of exercise that is appropriate for spine patients.
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