Laminectomy For Herniated Disk

WHAT YOU SHOULD KNOW:

• A laminectomy (lam-ih-NEK-tuh-mee) is surgery to take out the bony arches (lamina) of one or more of the bones in your back. A disk (tough sac filled with a jelly-like substance) sits between each of the bones in the back and neck. These disks act as shock absorbers. The cover of the sac may weaken and leak or bulge out. This is called a ruptured (RUP-sherd) or herniated (HER-nee-a-ted) disk. After a sudden jarring injury, the disk, or part of the disk, may herniate and need to be removed. Increasing age may also cause a disk to weaken and herniate.
  
  
• A herniated disk may put pressure on a nerve or the spinal cord. This pressure can make one leg or arm hurt or become numb. The muscles in that leg or arm may even get smaller. This is called muscle wasting. You will have tests, such as a CT scan or MRI, to see how bad your injury is. You may have already tried bedrest, medicines like ibuprofen (i-bew-PRO-fin), a chiropractor (KI-ro-prak-ter), or physical therapy. If these treatments did not make your problems go away, you may need surgery.

AFTER YOU LEAVE:

Medicines:

• Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Learn why you take each medicine. Ask your caregiver for information about your medicine. Do not use any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
  
  
• Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver. If you are taking medicine that makes you drowsy, do not drive or use heavy equipment.

• Your caregiver may give you anti-inflammatory (in-FLAH-muh-tor-e) medicine such as ibuprofen (i-bew-PRO-fin). This helps to decrease the swelling and redness (inflammation) of the area around your stitches or staples.
  
  
• If you are having pain or muscle spasms, your caregiver may give you medicine to relax the muscles in your back or neck.
  
  
• You may be given stool softeners to keep you from getting constipated (kon-stih-PA-ted). Constipated means it is hard to have a BM. Stool softeners make your BM softer so you do not need to strain when having a BM. You can buy stool softeners at a grocery or drug store.

Keep all appointments:

Ask your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Activity guidelines: You may feel like resting more after surgery. Slowly start to do more each day. Rest when you feel it is needed. Walking is good for you, but do not get overtired. Limit the times you walk up and down stairs to once a day, if possible, for 1 to 2 weeks.

• Driving: Ask your caregiver when you can begin to drive again. During the first weeks after surgery, ride in a car as little as possible. The motion of the car may cause your back to hurt.
  
  
• Lifting: Avoid lifting heavy objects. This means not to carry things like groceries or laundry. Do not lift anything over your head.
  
  
• Physical therapy: Your caregiver may want you to go to physical therapy. A physical therapist will help you with special exercises. These exercises help make your bones and muscles stronger.
  
  
• Sexual Activity : You may have sex when you feel ready. Some patients may have problems with sex after a laminectomy. These problems are usually short-term. Talk to your caregiver if you are worried. Caregivers can help you find ways to handle these problems.
  
  
• Work: Ask your caregiver when you can return to work.

Bathing: When you are allowed to bathe or shower, carefully wash your stitches or staples with soap and water. Afterwards, put on a clean, new bandage. Change your bandage any time it gets wet or dirty. If you cannot reach the bandage, ask someone else to help you change it. You may have steri-strips (thin strips of tape) on your incision. Keep them clean and dry. As they start to peel off, let them fall off by themselves. Do not pull them off.

Wearing a brace: A physical (FIZ-uh-kull) therapist may fit you for a brace to help support your back. You must wear the brace while walking or sitting in a chair. Ask your caregiver if you are allowed to go to the bathroom without the brace. You may need to wear the brace for about 3 months.

Constipation: If you are constipated, you may have a hard time having a bowel movement (BM) Do not try to push the BM out if it is too hard. Walking is the best way to get your bowels moving. Eat foods high in fiber to make it easier to have a BM. Good examples are high fiber cereals, beans, vegetables, and whole grain breads. Prune juice may help make the BM softer. Caregivers may give you fiber medicine or a stool softener to help make your BMs softer and more regular. You can also buy these medicines at a grocery or drug store.

Diet: Eat healthy foods from all of the 5 food groups: fruits, vegetables, breads, dairy products, meat and fish. Eating healthy foods may help you feel better and have more energy. It may also help you heal faster.

• Your caregiver may want you to eat a diet high in calcium. Foods high in calcium are milk, cheese, ice cream, fish, and dark green vegetables, like spinach. High calcium foods help prevent bone loss.
  
  
• It can take time getting used to a new diet. Special cook books may help the cook in the family find new recipes.

Drinking liquids: Men 19 years old and older should drink about 3.0 Liters of liquid each day (close to 13 eight-ounce cups). Women 19 years old and older should drink about 2.2 Liters of liquid each day (close to 9 eight-ounce cups). Good choices for most people to drink include water, juice, and milk. If you are used to drinking liquids that contain caffeine, such as coffee, these can also be counted in your daily liquid amount. Some food items such as soup and fruit also add liquid to your diet. Ask your caregiver how much liquid you should have each day.

Medicines: Caregivers may suggest that you take medicine for depression (sadness), swelling, and to help your muscles relax. Injections (needles) to numb (make you lose feeling in) painful areas may also help decrease pain.

Movement guidelines:

• Bending: When you stoop down to pick things up off the floor, bend your knees and keep your back straight. Do not bend at the hips
  
  
• Sitting: When you sit down, put your feet on a footstool. Do this so your knees are at the level of your hips or higher. Do not sit in soft or overstuffed chairs. Firm chairs with straight backs give better support. Use a raised toilet seat if needed.
  
  
• Sleeping: Make sure you have a firm mattress on your bed. When lying on your back, place 2 or 3 pillows under your knees and the lower part of your legs to raise them. When lying on your side, bend your knees and use a small pillow under your head and neck. This will decrease the strain on your shoulders, neck and arms. Do not lie on your stomach.
  
  
• Twisting: Do not twist at the waist.

Managing pain:

• Ice: Ice causes blood vessels to constrict (get small) which helps to decrease inflammation (swelling, pain, and redness). Ice is best started after surgery and for the next 24 to 48 hours afterwards. Put crushed ice in a plastic bag and cover it with a towel. Place this on the incision for 15 to 20 minutes every hour as long as you need it. Do not sleep on the ice pack because you can get frostbite.
  
  
• Pain Clinic: Treating pain after a laminectomy can be very difficult. The surgery may not get rid of your pain completely. Caregivers may suggest that you go to a pain clinic to help you learn new ways to live with pain. You will be shown different methods of pain control to try. You may try one or more of the following kinds of care or treatment for your pain:
  
  
  • Acupuncture: This treatment is based on a belief that our bodies have channels through which fluids flow. Caregivers will insert many small, thin needles just under your skin. This is believed to open the channels allowing fluids to flow better. This treatment may decrease pain and improve healing. Always see a caregiver for this treatment. Do not try to give this treatment to yourself.
    
    
  • Biofeedback: This training teaches your body to respond in a different way to stress. Teaching your body to relax can help you feel more in control. Caregivers may use a biofeedback machine so that you know right away when your body is relaxed. You can learn to do this without a machine. If you learn to take your pulse, you can make it slow down by thinking hard about it. This can work with breathing, temperature, and blood pressure too.
    
    
  • Cognitive Therapy: This therapy helps to make you aware of how you see things. You may have trouble seeing the good in things around you. Then you are more likely to feel depressed, sad or angry. Cognitive therapy teaches you how to see things in a more positive way.
    
    
  • Nerve blocks: This is a procedure where an anesthetic (an-iss-THET-ik) is injected through a needle. An anesthetic is a medicine that makes you lose feeling in an area. This procedure may used to help control pain after a laminectomy.
    
    
  • Nerve stimulation:
    
    
    • Transcutaneous Electrical Nerve Stimulation (TENS): This is a treatment that uses a small device giving out mild electrical impulses. These impulses produce a mild tapping, tingling or massaging feeling on your skin. This treatment may improve healing and reduce muscle cramps.
      
      
    • Epidural narcotic pumps: In this treatment, doctors place a small pump under your skin. It is connected to a thin tube placed near your spine. The pump gives you small amounts of pain medicine.
      
      
    • Transcranial magnetic stimulation (TMS): In this treatment, brain stimulation with small electrical currents may cause you to feel a decrease in your pain.
    
    
  • Physical therapy: Your caregiver may want you to go to physical therapy. A physical therapist will help you with special exercises. These exercises help make your bones and muscles stronger.
    
    
  • Relaxation and stress management techniques: Relaxation is a way to focus your attention on something other than your feelings. For instance, good smells may change your mood and help you relax. Good smells may also help your brain make special chemicals called endorphins (n-DOOR-fins). Endorphins are a natural body chemical that can decrease bad feelings and pain. For example, you may listen to music or take a bath with aromatherapy (uh-ro-muh-THAIR-uh-p) oils. Candles, massage oils, and scented bubble baths are ways that smells can be used.
    
    
  • Hydrotherapy: In these treatments, you may be placed into a warm or cold water bath or pool. Caregivers may show you exercises to do in the water. Hot or cold packs may also be placed on your body in the areas where you are feeling pain.
    
    
  • Surgery: Surgery may be done to destroy the nerves that go to painful areas.

Support: Having a spine injury can seem like a life-changing disease for you and your family. Accepting that you have a spine injury is hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family or friends about your feelings. Let them help you. Encourage those close to you to talk to your caregiver about how things are at home. Your caregiver can help your family better understand how to support a person with a spine injury.

Wellness hints:

• Eating and drinking:
  
  
  • Eat a variety of healthy foods such as fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meat and fish. Eating healthy foods may help you have more energy and heal faster. Ask your caregiver if you need to be on a special diet.
    
    
  • Men 19 years old and older should drink about 3.0 Liters of liquid each day (close to 13 eight-ounce cups). Women 19 years old and older should drink about 2.2 Liters of liquid each day (close to 9 eight-ounce cups). Follow your caregiver's advice if you must change the amount of liquid you drink. For most people, good liquids to drink are water, juices, and milk. If you are used to drinking liquids that contain caffeine, such as coffee, these can also be counted in your daily liquid amount. Try to drink enough liquid each day, and not just when you feel thirsty.
  
  
• Start exercising: Talk to your caregiver before you start exercising. Together you can plan the best exercise program for you. It is best to start slowly and do more as you get stronger. Exercising can help make your heart stronger, lower your blood pressure, and keep you healthy.
  
  
• Quit smoking: It is never too late to quit smoking. Smoking harms the heart, lungs, and the blood. You are more likely to have a heart attack, lung disease, and cancer if you smoke. You will help yourself and those around you by not smoking. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting.
  
  
• Avoid stress: Stress may slow healing and cause illness. Since it is hard to avoid stress, learn to control it. Learn new ways to relax, such as deep breathing. Talk to your caregiver about things that upset you.

CONTACT A CAREGIVER IF:

• Your stitches or staples are swollen, red, or have pus coming from them. This may mean they are infected.
  
  
• Your stitches or staples come apart.
  
  
• Your bandage becomes soaked with blood.
  
  
• Your pain is worse even after taking pain medicine.
  
  
• You have a fever (increased body temperature).
  
  
• You feel weak, numb, or have pain in your back, buttocks, or legs.
  
  
• You feel pain, redness, or swelling in one of your lower legs. This could mean there is a blood clot in your lower leg.
  
  
• You have questions or concerns about your surgery, medicine, or recovery.

SEEK CARE IMMEDIATELY IF:

• You have trouble breathing all of a sudden. This could be a sign that you have a blood clot in your lung. It could also mean that you are allergic to a medicine you are taking.
  
  
• You cannot control when you urinate or have a BM.
  
  
• You cannot feel or move your legs.
  
  
• You see any clear drainage from your surgery area on your skin or bandage.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Link to Page

Print Page

Email Page