The lamina, the rear section of the vertebra that covers the spinal canal, is removed during a technique known as spinal decompression surgery. The surgical technique relieves pressure on the nerves of the spinal cord and expands the spinal canal. A laminectomy is another name for this procedure. The major target of pressure is bony growths within the spinal canal, which can begin in persons with spine arthritis. These growths, which are sometimes referred to as bone spurs, are typical, especially as individuals age. The bone channels through which the spinal cord and nerves flow are opened during decompression surgery (laminectomy), allowing them greater freedom to move freely.
Chronic pain, numbness, and muscular weakness in the arms or legs can be caused by narrowing or stenosis of the spinal and nerve root canals. When non-surgical therapies such as medication, physical therapy, or injections fail to ease symptoms, spine decompression surgery is usually recommended.
Cost of Spine Decompression Surgery in India
For foreign patients, the cost of endoscopic spine decompression surgery in India ranges from USD 4500 to USD 5800.
The patient must spend one day in ICU, four days in the hospital, and ten days out of the hospital. The overall cost of therapy will vary depending on the diagnosis and the facilities selected by the patient.
Factors Influencing Spinal Decompression Surgery Cost
The ultimate cost of the treatment is affected by the patient’s health and choices. Among these elements are:
- Fees for the doctors/medical team and OT.
- The expense of medication.
- Techniques for standard diagnostic and testing.
- Choosing a general hospital, a twin-sharing hospital, or a single-room hospital and room
- The severity of the sickness
- If a postoperative problem such as nerve damage or paralysis occurs.
- If relevant, the cost of blood products.
- The age of the sufferer.
- A lengthy hospital stay.
- A physiotherapist’s fee.
- If the patient is not a local, the cost of housing during follow-up visits.
Spinal decompression surgery
- Microdiscectomy is one of the least intrusive treatments for leg pain such as sciatica, a disease in which pain from pressure on the nerve in the lower back radiates down the leg caused by a lumbar herniated disc.
- The herniated section that is in touch with the nerve root is removed through a tiny incision in this technique.
- Lumbar laminectomy (open decompression): A lumbar laminectomy is an open decompression treatment used to relieve lumbar spinal stenosis discomfort. During this surgery, the lamina or bone in the back of the vertebra at one or more segments is removed to alleviate pressure on the spinal cord or nerves.
- Corpectomy: A piece of the vertebra is removed during the corpectomy treatment to alleviate strain on the spinal nerves. It is most commonly used in cervical surgery.
- Laminotomy: Similar to a laminectomy, except a hole is formed in the lamina and a tiny piece of the lamina and ligaments are removed. This is usually done on one side to retain the natural support of the lamina and limit the possibility of postoperative spinal instability.
- A foraminotomy is a procedure that removes bone from the region surrounding the neural foramen to alleviate a pinched nerve. When the height of the foramen has collapsed due to disc degeneration, this method is employed.
What elements should one take into account before deciding on a spinal decompression procedure?
The optimum technique is determined by a number of criteria. A doctor provides a suggestion based on the patient’s general health history and the severity of the injury.
In general, doctors prefer “stepped” methods. They begin with less intrusive and less expensive methods to assess the damage response. If these treatments fail, surgery may be employed as the next step.
The doctor may do a number of tests in order to better understand the harm. These tests might include:
- Scanners for bones: A bone scan is an imaging process that checks the bones for cancer, infections, or fractures. Your doctor orders a bone scan to determine the source of your back discomfort.
- Diskography: Your healthcare professional will inject a dye that appears on X-rays and other images into your back. A computed tomography (CT) scan is then used to acquire pictures. Diskography may detect disc deterioration.
- Electrical examinations: Electromyography is recommended by the doctor to monitor the electrical activity in the muscles and nerves. The speed at which electrical impulses move from the nerves to the brain is measured through evoked potential studies.
- Imaging diagnostics: A doctor utilises diagnostic imaging to obtain “pictures” of the inside of your body. These photos may indicate the source of your suffering. Specific imaging includes MRIs, CT scans, and X-rays.
Patients’ Eligibility for the treatment
If you have: Decompression may be a possibility.
- Significant leg or foot pain worse than back pain that does not improve with medicine or physical therapy
- A difficulty standing or walking that reduces one’s quality of life
- Diagnostic methods such as MRI, CT, and myelogram demonstrate stenosis in the central canal or lateral recess.
This therapy requires a certain procedure to be followed.
- Anaesthesia refers to a procedure performed under general anaesthesia.
- Anaesthesia: A skin incision is made in the centre of your back above the relevant vertebrae.
- The length of the incision is determined by the number of laminectomies that will be performed.
- When the strongback muscles are divided along the middle and moved to either side, the lamina of each vertebra is exposed.
- After the bone has been exposed and an X-ray has been obtained to identify the proper vertebra, the lamina at one or more segments is removed during a laminectomy or laminotomy.
- The decompression of the spinal cord:-After the lamina and ligamentum flavum have been removed, the dura mater, which acts as the spinal cord’s protective coating, may be viewed. The surgeon can delicately withdraw the sac that covers the spinal cord and nerve root to remove bone spurs and swollen ligaments.
- Reduce spinal nerve compression:-The facet joints just above the nerve roots may be undercut or shortened to allow greater room for the nerve roots. A foraminotomy is a technique that expands the neural foramen, which is where the spinal nerves exit the spinal canal. If a herniated disc is the source of the compression, the surgeon will perform a discectomy.
- Fusion: If there are laminectomies to many vertebrae or spinal instability, a fusion may be done. Two vertebrae are fused together using a bone graft and hardware such as plates, rods, hooks, pedicle screws, or cages. The goal of the bone transplant is to join the vertebrae above and below into a single piece of bone. Fusion may be produced in a number of ways. Personal preference and doctor guidance will determine which is best for the patient.
- The most common kind of fusion is posterior-lateral fusion.
- Closure: Sutures or staples are used to seal muscle and skin wounds.
- The degree of decompression employed will influence the length of your hospital stay. Surgery typically necessitates a one to three-day hospital stay, followed by a four to six-week recuperation period.
- The staples or stitches are removed 10 to 14 days after the procedure.
Limitations after surgery:
- It’s not a good idea to sit still for an extended period of time.
- Anything heavier than 10 pounds cannot be lifted.
- Never bend over or twist your waist.
- Don’t smoke. Smoking prevents healing.
- Don’t engage in strenuous tasks like housekeeping, gardening, or sexual activity.
- For the first two to three days after starting painkillers or muscle relaxants, refrain from driving. If your pain is under control, you can drive.
- Don’t drink alcohol. The risk of bleeding and blood loss both rise. Avoid mixing alcohol and painkillers as well.
Recovery time following surgery
- Patients go back to their homes one to four days following surgery. This will depend on one’s general health and the specific sort of surgery they received.
- The patient will be encouraged to get up and walk around by the medical staff as soon as possible following the procedure, generally starting the next day. This is due to the fact that being inactive increases the risk of developing a deep vein thrombosis (DVT), whereas being active promotes faster recovery.
- After surgery, a physiotherapist aids in the process of regaining strength and movement.
- It’s important to begin at home gently and build up to more activity each day. Some help at home is usually needed for at least the first week after surgery.
- Recovery is sped up by exercise. Follow the physiotherapist’s advice on exercise.
- One could be requested to schedule one or more follow-up appointments at the hospital in the weeks after the operation to check on the condition.
- A person may often return to their job after 4 to 8 weeks if it isn’t too demanding.
- Depending on the extent of the treatment, it typically takes 2 to 6 weeks for most individuals to feel confident driving again.
- Consult a doctor if you have any unexpected symptoms or pain.
Risks involved include:
All procedures come with some level of risk. General hazards associated with surgery include:
- bleeding-related blood clot risk (DVT)
- persistent ache or numbness
- loss of bladder or bowel control
- contamination of the spine
- permanent discomfort or nerve damage. The spinal cord or nerves might be harmed during any surgery on the spine.
- Damage may cause numbness or even paralysis.
- From the spine, fluid is dripping
Concurrent spinal fusion and laminectomy procedures provide a greater risk of complications.
- Permanent pain or nerve damage
- Bones that don’t fuse together
- Deep vein thrombosis (DVT)
- Equipment damage
- Bone graft migration
- nearby segment illness