14 August, 2017
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Complications of Lumbar Laminectomy
A laminectomy can relieve pressure on the spinal nerves that causes pain and impairs function in the neck or back, according to the American Academy of Orthopaedic Surgeons. The surgeon removes a small piece of bone above the affected nerve and the disc under the nerve, or both, decompressing the area to allow the nerve to heal. The surgeon may also perform a spinal fusion to prevent instability.
Complications of lumbar laminectomies, which involve the area of the spine between the neck and the small of the back, depend on the underlying cause of the pain and the general health of the patient.
One of the most common complications of any spinal operation involves the patient continuing to experience pain after surgery, according to the University of Maryland Medical Center. Although most lumbar laminectomy patients with leg pain feel better immediately, approximately 10 to 20 percent will continue to have problems until the nerve heals, according to Peter F. Ullrich, M.D., in a Nov. 4, 2009 report published on "Spine-Health."
In fact, the trauma of the surgery may cause the pain to increase due to swelling around the nerve root, although this effect should subside within the first three months. Numbness and tingling in the leg, however, may take up to a year to resolve. Chronic pain after a laminectomy, sometimes called failed laminectomy syndrome, may require a team approach that includes exercise, psychotherapy, an external electrical nerve stimulation unit and stress reduction, says the Cleveland Clinic.
Nerve damage in lumbar laminectomy procedures occurs in about one in 1,000 cases, notes Ullrich. Nerve damage may occur when a bone fragment continues to pinch the nerve or the nerve is dissected during the procedure. Trauma during surgery can cause permanent muscle weakness or paralysis in the affected area, but this outcome is rare, according to A. Jay Khanna, M.D., in a report published by the American Academy of Orthopedic Surgeons.
Damage to the nerves that control the bowels or bladder causes incontinence, or loss of urinary control, in one out of 10,000 patients, notes Khanna. Traumatizing nerves that affect the pelvic region may cause sexual dysfunction, according to the University of Maryland Medical Center.
Patients with spinal stenosis, a narrowing of the spinal canal, may experience pain relief for several years after surgery followed by a return of the symptoms, according to Ullrich. In those cases, the bone may grow back at the same point or at a different portion of the spine, causing pain in the back and the leg. Pain from a recurrent herniated disk, a fluid-filled shock absorber between each pair of vertebrae in the spine, may return within three months of surgery in about 5 to 10 percent of patients.
Five to 10 percent of patients undergoing lumbar laminectomy experience instability in the spine after surgery, says Khanna. The problem may be caused by continuing damage to the area from degenerative joint disease or from removing too much of the bone structure. In either case, a surgical spinal fusion may be required to restore stability and reduce pain.
- spine x-ray image by Julianna Olah from Fotolia.com