What to Expect After a Laminectomy

If you experience back pain that grows severe, your doctor may recommend surgery depending on the cause. Over the centuries, back pain has been constantly a growing condition. You may be facing a lumbar laminectomy at any time.

During a Laminectomy

Laminectomies are done under general anesthesia, which means you will be asleep all throughout the surgery. Your blood pressure, oxygen supply, and heart rate are recorded and monitored during the surgery. The moment you go under, these are the things that will or can happen:

• The surgery begins with incisions on your back. The surgeon moves your muscles aside to expose your spine. Your affected lamina is removed using small instruments.
• In case you have a herniated disc, the surgeon will cut and remove it as well as any pieces of the disc that may have broken off.
• In case your vertebrae has slipped aside, or if you have spine curvature, your surgeon will stabilize your spine through a procedure known as spinal infusion. During this process, your vertebrae is grafted with bone or metal rods are fixed on them.
• Your incisions are stitched after the surgery. 

What to Expect After Your Surgery From Day 1 to Year 1!:

Your doctor and his team will need to see you throughout your return to normal after your surgery. The following is an outline of what to expect. Use it as a guide to help you on your road to recovery.

Length of Stay

How long you stay in the hospital depends on the type of surgery you had, your condition, and your doctor's decisions. Typically, with a cervical laminectomy, you will be in the hospital for at least two days. With a lumbar laminectomy, you may stay in the hospital also for two days. Fusion laminectomy may require up to six days in the hospital. In case your lumbar laminectomy involves invasive fusions, you may require only a 24-hour hospital stay. Your general health and age will also influence the time you stay in the hospital. The following apply to a person whose laminectomy involves no additional, more complicated procedures.

During Your Stay:

DAY 1

On the first day, expect to rest and be in the company of physical therapists, who will help you stand up and walk with their help as needed. You will be given medications as your pain requires or you may be given a Personal Analgesia Pump (PCA), which allows you to control the delivery of your pain medications.  

DAY 2

Drainage tubes fixed to your incisions will be removed on the second day. Your PCA will be replaced with oral painkillers, and your physical therapists will help you do more walking and sitting, as well as educate you more on your physical rehabilitation. 

DAYS 3 to 5

The order of the day is rehabilitation and getting you back to eating and voiding normally by this time. Your doctor will usually decide on your date of discharge around this time, based on your individual condition and performance and the clearance of your physical therapists. If needed, you may be transferred to the rehabilitation unit at this point. At this unit, your surgeons may still visit to check on your progress but your physiatrist takes over as the primary decision-maker. 

Your Discharge:

Your discharge will involve plenty of activities going on. You will be given prescriptions and instructions. You will have to arrange for your transport home, since you will not be allowed to drive. Ensure your transportation is you can get in and out of without difficulty. You will be expected back in the hospital for a check-up after ten days, so book your appointment before you leave the hospital. 

What to expect after you go home:

THE FIRST WEEKS AT HOME

You will be very tired during the first few days after the surgery. You will be spending half the time in bed, resting. You will, however, be able to use the bathroom and move about without help.  Still, you should arrange for someone to help you in the first two weeks so you don't strain yourself. You will be using your pain relievers as prescribed by your doctor.

Your activities should be few but include a progressive walking program. A treadmill or stationary bicycle is allowed, though may be too much for you just yet. You must not pull or lift anything heavier than ten pounds, nor should you be doing any bending down, twisting, or any strenuous work, including housework. You will also have to take some time off from sexual activities until your doctor gives you the go-ahead.

You must keep your wound as clean and dry as possible, and covered with a dry and sterile 4x4 piece of gauze. You'll have to change this daily. When you shower, protect the wound by covering it with cling film secured with surgical tape to keep the incision dry. After your shower, remove the cling film and dress your wound with a fresh piece of gauze. Do not use any oil, ointment, or powder on the incision unless prescribed by your doctor.

You should write down the schedule for your medications and record the time you take each one. You should be careful with the prescriptions as narcotic prescriptions should always be adhered to, and inform your doctor ahead of time when running low on supply so you have time to get a new prescription filled. 

As the weeks go by, you may gradually add to your activities, but remember that the restrictions on your bodily movements still apply. Whether you can return to work will depend on the type of surgery you underwent, the kind of work you do, and your own levels of comfort and energy. Generally, a laminectomy will allow you to return to a sedentary job within two weeks. A more physically demanding job along with fusion surgery may require a two to three month recovery period. Discuss your situation with your doctor, who will give you a good estimate of your required recovery time given the relevant factors. 

ONE MONTH AFTER SURGERY

Your doctor will increase your level of activity after your second post-surgery visit, which should occur around six weeks after the laminectomy. You may be allowed to progress to basic exercises, usually those to strengthen your abdominal and back muscles while avoiding those that require a lot of movement of the lumbar spine and pelvis. Again, the level and kinds of physical activity at what point in time the doctor will advise will depend on the type of surgery you had. The doctor might also start your physical therapy at this time.

THREE MONTHS AFTER SURGERY

Three months after the surgery, you will have another appointment with your doctor. If you had a laminectomy, the doctor might give you the go-ahead for all kinds of activity at this point. The doctor may also put you on a more vigorous physical therapy regimen. If fusion surgery was what you underwent, the doctor will usually order x-rays to check on how well the fusion has healed, and you will have to observe the restrictions on your movements for another three months.    

SIX MONTHS AFTER FUSION SURGERY

At six months, your fusion should be mature or approaching maturity. X-rays will be obtained to assess the fusion. Even though the fusion may be mature, it will take up to twelve months for it to be strong. Nonetheless, your doctor may relieve you of most of the restrictions at this point but still retain focus on your rehabilitative agenda.

ONE YEAR AND BEYOND

An annual check-up is recommended for anyone who has had a major spine surgery. The doctor will review your exercise program and recommend ways to optimize your core's strength, endurance, and agility, and discuss with you lifestyle improvement tips to benefit your spine down the road. If you had a spinal fusion, the doctor will order x-rays and assess the fusion and contiguous areas of the spine.