When a patient is experiencing compression of the nerves in the spine that is accompanied by little to no instability in the spine a procedure may be performed to relieve that pressure accompanied by spinal fusion. The lack of weakness in the patient permits the physician to perform a spinal fusion using bone grafts without any supporting instrumentation, strengthening the surgical site without the use of pins, rods, screws, or cages.
What Makes A Laminectomy Necessary?
The spinal cord can be found in the spinal column, an alternating series of discs and vertebrae that comprise the central structural support for the body. This nerve structure serves as a conduit for all the information, sensations, and instructions that the brain sends and receives from the rest of the body. In individual patients bone spurs will begin to form, constricting the channel and compressing the nerves in a phenomenon known as spinal compression caused by stenosis. Stenosis is the word for a narrowing of channels in the body. A laminectomy is performed when these bone spurs begin to impede the spinal cords ability to transmit information, resulting in numbness, weakness, tingling, and even pain in the extremities. In extreme cases, loss of mobility and problems with bladder and bowel control can occur.
Why Would My Doctor Order An Uninstrumented Laminectomy?
Laminectomies come in two varieties, instrumented and uninstrumented. When a patient has little to no instability in their spinal column around the target site an uninstrumented laminectomy with fusion may be necessary. The lack of weakness means that the patient can recover from the surgery with only a bone graft to stabilize the area and a little care taken during recovery.
Where Do They Get The Bone Grafts Used In The Fusion?
Typically the bone grafts used in this operation have been harvested from the patients own iliac crest, the upper ridge of the hip bone. This graft comes with the benefit of being the patients own tissue, as well as living material that can aid in the fusing of the bones at the surgical site. In other cases, the bone comes from a cadaver, and shavings from the vertebrae surrounding the target location are used to ensure that living tissue can aid in the fusion. Bone grafts harvested from the patient are known as autografts, while bone grafts taken from donors are known as allografts.
What Will It Be Like Recovering From This Procedure?
Patients who undergo an uninstrumented laminectomy with fusion will spend a few days in the hospital following the operation under observation. During this time they will be encouraged to take walks in the hall and monitored to determine how they’re responding to the surgery. Once they return home, they will be advised to avoid any form of strenuous activity, especially that which puts additional strain on the back, for six weeks. Following a six week visit, the patient can return to their normal activities.
If you think you may be a candidate for an uninstrumented laminectomy with fusion, it’s time to consult your pain management doctor in Las Vegas, NV. Dr. Yevgeniy Khavkin will schedule an exam in combination with a consultation to determine if this procedure is appropriate in your case.