What is a laminectomy?

Back or neck pain that interferes with normal daily activities may need surgery for treatment. Laminectomy is a type of surgery in which a surgeon removes part or all of the vertebral bone (lamina). This helps ease pressure on the spinal cord or the nerve roots that may be caused by injury, herniated disk, 椎管狭窄(椎管狭窄), or tumors. A laminectomy is considered only after other medical treatments have not worked.

为什么我可能需要做椎板切除术?

Low back or neck pain can range from mild, dull, and annoying to persistent, severe, and disabling. 脊柱疼痛会限制你的活动能力. 椎板切除术可以减轻脊神经的压力, treat a disk problem, 或者从脊柱上切除肿瘤.

One common reason for having a laminectomy is a herniated disk in the spine.

由于受伤或磨损，磁盘可能移位或损坏. When the disk presses on the spinal nerves, this causes pain, and sometimes numbness or weakness. The numbness or weakness will be felt in the body part where the nerve is involved, often the arms or legs. 椎间盘突出最常见的症状是坐骨神经痛. This is a sharp, 坐骨神经疼痛, 从臀部延伸到大腿，并向下延伸到腿后部.

如果药物治疗不再有效，手术可能是一种选择. 一些治疗疼痛的药物包括:

• Changes in activity
• Medicines, such as muscle relaxants, anti-inflammatory medicines, and pain relievers
• Spinal injections
• 物理康复，物理治疗，或者两者都有
• Occupational therapy
• 减肥(如果超重)
• Smoking cessation
• 辅助装置，如机械背部支撑物

Laminectomy is usually done for back or neck pain that continues after medical treatment. Or it is done when the pain is accompanied by symptoms of nerve damage, 比如手臂或腿麻木或无力. Loss of bowel or bladder control from pressure in the cervical or lumbar spine also usually needs surgery.

There may be other reasons for your healthcare provider to recommend a laminectomy.

椎板切除术的风险是什么?

与任何外科手术一样，并发症也会发生. 一些可能的并发症包括:

• Bleeding
• Infection
• 腿部或肺部有血块
• 脊髓或神经根损伤
• 与使用全身麻醉相关的风险

手术区域的神经或血管可能受伤. 这会导致虚弱或麻木. The pain may not be eased by the surgery or may become worse, although this is rare.

根据您的具体健康状况，可能会有其他风险. Be sure to discuss any concerns with your healthcare provider before the surgery.

我该如何为椎板切除术做准备?

• Your healthcare provider will explain the surgery to you and offer you the chance to ask any questions that you might have about the procedure.
• You will be asked to sign a consent form that gives your permission to do the surgery. 仔细阅读表格，如果有不清楚的地方问问题.
• 除了完整的健康史, your healthcare provider may do a physical exam to make sure that you are in good health before undergoing the procedure. 您可能会进行血液检查或其他诊断检查.
• Tell your healthcare provider if you are sensitive to or are allergic to any medicines, latex, tape, 麻醉药物(局部和全身).
• Tell your healthcare provider of all prescribed and over-the-counter medicines and herbal supplements that you are taking.
• Tell your healthcare provider if you have a history of bleeding disorders or if you are taking any blood-thinning (anticoagulant) medicines, aspirin, 或者其他影响血液凝固的药物. 你可能会被告知在手术前停止使用这些药物.
• If you are pregnant or think you could be, tell your healthcare provider.
• Follow any directions you are given for not eating or drinking before the surgery.
• 在手术前，你可以服用镇静剂来帮助你放松.
• You may meet with a physical therapist before your surgery to discuss rehabilitation.
• 手术后某些活动可能会受到限制. Arrange for someone to help you for a few days with the household activities and driving.
• Based on your health condition, your healthcare provider may have other instructions for you.

在椎板切除术中会发生什么?

椎板切除术通常需要住院治疗. Procedures may vary depending on your condition and your doctor's practices.

A laminectomy may be done while you are asleep under general anesthesia. 也可以在脊柱麻醉下清醒时进行. If spinal anesthesia is used, you will have no feeling from your waist down. Newer techniques are being developed that may allow a laminectomy to be done under local anesthesia as an outpatient. 你的医生会提前和你讨论.

一般来说，椎板切除术遵循以下步骤:

1. 他们会要求你脱下衣服，给你一件长袍.
2. 可以在你的手臂或手上进行静脉注射.
3. Once you are under anesthesia, a urinary drainage catheter may be inserted.
4. If the surgical site is covered with extra hair, the hair may be clipped off.
5. You will be positioned either on your side or belly on the operating table.
6. 麻醉师会持续观察你的心率, blood pressure, breathing, 以及手术期间的血氧水平.
7. The healthcare staff will clean the skin over the surgical site with an antiseptic solution.
8. 外科医生将在选定的椎体上切开(切口).
9. 外科医生将把肌肉分开.
10. The surgeon removes the bony arch of the posterior part of the vertebra (lamina) to ease the pressure on the nerves in the area. This may involve removing bone spurs or growths, or removing all or part of a disk.
11. 在某些情况下，脊柱融合术可以同时进行. During a spinal fusion, the surgeon will connect 2 or more bones in your spine.
12. 切口将用缝线或手术订书钉缝合.
13. 将使用无菌绷带或敷料.

椎板切除术后会发生什么?

In the hospital

After the surgery, you will be taken to the recovery room for observation. 一旦你的血压, pulse, 呼吸稳定，你也很清醒, 你会被带到你的病房. Laminectomy usually requires that you stay in the hospital one or more days.

You will most likely start getting out of bed and walking the evening of your surgery. Your pain will be controlled with medicines so that you can take part in the exercise. You may be given an exercise plan to follow both in the hospital and after discharge.

At home

Once you are at home, it's important to keep the surgical incision area clean and dry. 你的医疗保健提供者会给你具体的洗澡指导. The surgical staples or stitches are removed during a follow-up office visit.

Take a pain reliever for soreness as recommended by your healthcare provider. Aspirin or certain other pain medicines may increase the chance of bleeding. 一定要只服用推荐的药物.

告诉您的医疗保健提供者以下任何情况:

• Fever
• Redness, swelling, bleeding, or other drainage from the incision site
• 切口周围疼痛加剧
• 腿部、背部或臀部麻木
• 排尿困难或膀胱或肠道失控

在你的医生告诉你可以之前不要开车. 不要弯腰捡东西或拱背. 您的提供者可能会告诉您限制其他活动.

Your healthcare provider may give you other instructions after the procedure, 这取决于你的具体情况.

Next steps

在您同意测试或程序之前，请确保您知道:

• The name of the test or procedure>/li>
• 你进行测试或程序的原因
• 期待什么样的结果?它们意味着什么
• 测试或程序的风险和益处
• 可能的副作用或并发症是什么
• 你在何时何地进行测试或程序
• Who will do the test or procedure and what that person's qualifications are
• 如果你不做检查或不做手术会怎么样
• 有没有其他的测试或程序可以考虑
• 你何时以及如何得到结果
• Who to call after the test or procedure if you have questions or problems
• 你需要支付多少检查费用