When you’re experiencing pain, numbness, or other symptoms due to spinal stenosis (a narrowing of the spinal canal due to trauma, degenerative disorders, tumors, etc.), it may seem like there is no end in sight. Luckily, surgery is often very effective to address these issues. An open laminectomy and fusion can provide you with the chance to live a more normal lifestyle with improved pain.
What Is Open Laminectomy and Fusion?
An open laminectomy and fusion is a combination of surgical procedures that provide not only relief from nerve compression but also reinforces spinal stability to support areas that have been compromised.
These procedures require general anesthesia. Your surgeon will create an incision along your spine over the affected vertebrae. The muscles will be separated to allow access to the bones of your spine. The laminae are the back part of each vertebrae, forming the roof of the spinal canal. The lamina is removed to relieve pressure on your spinal nerves, allowing it to return to a more normal position and alleviate irritation.
Once the laminectomy is completed, the fusion part of the procedure is performed. This surgery utilizes bone grafts to help create a “bony bridge” between two or more vertebrae. In order to enhance the success of bony healing, additional support is provided with metallic implants while the bones grow together.
Once both surgeries have been performed, your surgeon will carefully close the multiple muscle layers over the top of the surgical site. Your skin incision will be closed with stitches, staples, tissue glue or a combination of some of or all three.
There are also minimally invasive techniques to perform these procedures, particularly if the area of the spine that needs to be decompressed is limited. These minimally invasive techniques are performed with less soft tissue, muscle, trauma that leads to potentially less post-operative pain, shorter hospitalization, and a faster recovery. Your surgeon will determine if you are a candidate for either the open or minimally invasive fusion.
Recovery After Open Laminectomy and Fusion
After your surgery, you will be taken to the recovery area. Here you will be monitored and your pain medication will be modified as needed. Once you are awake and ready, you’ll be moved to your room for the rest of your stay.
You can expect to stay in the hospital for several days following your procedure. This allows you to recover, work with physical therapy, and transition to oral pain medication. It’s not uncommon to be up and walking the next day after your surgery.
Once it’s time to go home you will need to take it easy. Take your pain medications as prescribed. You may feel tired – this is normal. Be sure to rest as much as you can so that your body can heal. Taking gentle walks a few times a day will aid in your recovery. Having assistance with daily tasks such as cooking, light cleaning, bathing and dressing is particularly helpful for the first several weeks after surgery.
As your surgical site begins to heal you will notice your energy increasing. It may be tempting to jump back into your normal routine but be sure to follow your surgeon’s orders. You shouldn’t lift anything too heavy. If you’re directed to wear a brace or other aid, use it as prescribed. You may be able to return to work after a couple of weeks if you work in a light-impact job. Strenuous occupations will require more time to heal before resuming your normal workload.
Between the fourth and sixth week, you will need to visit your surgeon for a follow-up. Tracking your progress will include answering questions, an examination of the incision site, and x-rays to monitor the healing of your bone grafts. You may be released at this time to begin resuming more of your activities.
Typically, you can expect that within eight to 12 weeks you’ll be healed enough to get back to the majority of your normal activities, but aggressive athletics may require a longer recovery.
Risks of Open Laminectomy and Fusion
Although there are many potential benefits of having an open laminectomy and fusion, it can, like any surgery, carry risks. These include:
- Neurological injury
- Infection
- Bleeding
- Lower extremity blood clots
- Leakage of spinal fluid
- Failure of the bones to heal that may lead to chronic pain
- Breakdown of the remaining mobile spinal segments next to your fusion
Is an Open Laminectomy and Fusion Right for Me?
Making the choice to have an open laminectomy and fusion may be one of the biggest decisions of your life. Setting reasonable expectations and knowing what the risks and benefits are will make it much easier to decide if these procedures are right for you. Some indications for an open laminectomy and fusion include:
- Relief from the pain or neurological symptoms associated with a spinal degenerative disease.
- Stabilization of your spine following removal of a spinal tumor or infection.
- Correction of a degenerative spinal deformity
Working with your surgeon, you can explore the benefits that having a laminectomy and fusion can offer you. You deserve to get back to your active, pain-free life!