What is a laminectomy?
The term “lamina” refers to the section of bone that forms the back half of the spinal canal. The term “ectomy” refers to surgical removal, so a laminectomy is the removal of the area of bone in the back of the circular ring around the spinal cord. When is a laminectomy performed? A laminectomy is performed when a nerve root or the spinal cord is being compressed. The most common culprit causing the nerve compression is an injury to the intervertebral disc. By removing the back section of bone, it allows the nerve root or spinal cord to slide backwards (away from the disc material) reducing compression and irritation of the nerves.
What are the symptoms of a pinched nerve?
Since the nerve roots that exit the neck and back control
muscular movement and skin sensation of the arms and legs, a person will notice a sharp burning sensation down an arm or leg, a numb/tingle sensation to a section of arm or leg, and/or weakness of a specific muscle group in the arm/leg.
When does a “pinched nerve” require surgery?
Most “pinched nerves” respond well to conservative care (chiropractic manipulation and rehabilitation). However, if weakness of the leg is noted and/or loss of bowel/bladder is present, decompressive surgery is indicated.
Why does post laminectomy syndrome develop?
Following a laminectomy surgical procedure, the body’s normal healing process will begin to repair the surgical area. The body will not just leave an empty cavity but will fill the area with scar tissue. If the scar tissue binds to the nerve root or forms too densely, it may cause a “pinching” of the nerve and produce symptoms of numbness/burning and/or weakness of the leg just like prior to surgery. Early movement is the key. Your surgeon will recommend a progressive walking program that will activate the back muscles and stretch the scar tissue to avoid post-laminectomy syndrome. Your surgeon will refer you to rehabilitation to further facilitate strengthening and stretching of the surgical scar tissues.
How prevalent is post laminectomy syndrome?
According to a study performed by Wheeler, published in eMedicine (July 2007), 10-15% of laminectomy procedures develop some degree of post laminectomy syndrome.
What can I do to prevent it?
Quality postsurgical rehabilitation – A good postsurgical rehabilitation program will include activities that glide the nerve roots to prevent nerve root adhesions, stretch/strain the scar tissue to promote a stronger and more mobile collagen scar tissue, and develop adequate core strength to reduce the incidence of re-injury of the previously injured disc and ligament structures. While the majority of laminectomy cases do not develop into post laminectomy syndrome, there are currently no predictors for those Individual’s more prone to poor outcomes. Therefore, I highly recommend participating in post surgical rehabilitation to reduce potential complications.
Todd R. Custer, D.C., A.T.C. – Doctor Custer is a doctor of chiropractic and certified athletic trainer, and has been rehabilitating injured athletes at the high school, collegiate, and professional levels (Philadelphia Eagles Football Club) since 1994. Dr. Custer graduated from Texas Chiropractic College summa cum laude, and is currently treating patients at the Better Care Chiropractic & Physical Therapy.