Our Summary

This research paper discusses a cheaper and effective way to perform two types of spinal surgeries (laminectomy and laminoplasty) using a tool that is not typically used for these surgeries: Tudor Edwards rib shears. These are a type of scissors used in chest surgeries.

The researchers used these rib shears in 18 spinal surgeries and found that they were successful in every case, causing no harm to the protective covering of the spinal cord (dura) or the structures beneath it.

The process was quicker, safer, and easier in the neck (cervical) and upper back (dorsal) regions compared to the lower back (lumbar) region, due to the difference in the thickness and angle of the bone in these areas.

The researchers concluded that using Tudor Edwards rib shears for these spinal surgeries could be a good alternative, especially for medical professionals who don’t have access to more expensive tools. They also found that the unique cut edges from the shears could help prevent the implanted bone from sinking, making it easier to fix it in place.

FAQs

  1. What are Tudor Edwards rib shears and what are they typically used for?
  2. What were the results when Tudor Edwards rib shears were used in spinal surgeries?
  3. Why might Tudor Edwards rib shears be a good alternative for certain spinal surgeries according to the research?

Doctor’s Tip

A doctor might tell a patient undergoing a spinal laminectomy that using Tudor Edwards rib shears can be a cost-effective and safe option for the surgery. The unique cut edges from the shears can help prevent the implanted bone from sinking, making it easier to fix it in place. This alternative tool may make the surgery quicker, safer, and easier in certain regions of the spine. It’s important for the patient to discuss this option with their surgeon to see if it is appropriate for their specific case.

Suitable For

Patients who may be recommended for spinal laminectomy include those suffering from conditions such as spinal stenosis, herniated discs, bone spurs, or other spinal cord compression issues. These conditions can cause symptoms such as pain, numbness, weakness, or difficulty walking.

Spinal laminectomy is typically recommended when conservative treatments such as physical therapy, medications, or injections have not provided relief. It is a surgical procedure that involves removing a portion of the lamina, the bony arch on the back of the vertebra, to relieve pressure on the spinal cord or nerves.

Patients who are experiencing severe symptoms, progressive neurological deficits, or loss of bowel or bladder control may be candidates for spinal laminectomy. It is important for patients to discuss their symptoms and treatment options with their healthcare provider to determine if spinal laminectomy is the best course of action for their specific condition.

Timeline

Before spinal laminectomy:

  1. Patient experiences persistent back pain, numbness, or weakness in the legs.
  2. Patient undergoes diagnostic tests such as X-rays, MRI, or CT scans to determine the cause of their symptoms.
  3. After consulting with a spine specialist, it is determined that the patient requires a spinal laminectomy to relieve pressure on the spinal cord or nerves.

During spinal laminectomy:

  1. Patient is put under general anesthesia.
  2. Surgeon makes an incision in the back over the affected area.
  3. Soft tissues are moved aside to expose the lamina (part of the vertebra) that needs to be removed.
  4. Using specialized tools, the lamina is removed to decompress the spinal cord or nerves.
  5. Any bone spurs or herniated discs contributing to the compression are also removed.
  6. The incision is closed with stitches or staples.

After spinal laminectomy:

  1. Patient may experience some pain and discomfort at the surgical site.
  2. Physical therapy may be recommended to help regain strength and flexibility in the back.
  3. Patient may need to limit activities and avoid heavy lifting for a certain period of time.
  4. Follow-up appointments with the surgeon are scheduled to monitor recovery and address any concerns.
  5. Over time, the patient should experience relief from their previous symptoms and improved mobility.

What to Ask Your Doctor

  1. What is a spinal laminectomy and why is it needed?
  2. What are the potential risks and complications associated with a spinal laminectomy?
  3. How is a spinal laminectomy typically performed and what is the recovery process like?
  4. How does using Tudor Edwards rib shears for a spinal laminectomy compare to traditional methods?
  5. What are the advantages and disadvantages of using Tudor Edwards rib shears for a spinal laminectomy?
  6. Are there any specific criteria or factors that make a patient a good candidate for a spinal laminectomy using Tudor Edwards rib shears?
  7. How experienced are you in using Tudor Edwards rib shears for spinal surgeries?
  8. What is the success rate of using Tudor Edwards rib shears for spinal laminectomy procedures?
  9. Are there any potential long-term effects or considerations to keep in mind when using Tudor Edwards rib shears for a spinal laminectomy?
  10. Are there any alternative treatment options or techniques that could be considered for a spinal laminectomy?

Reference

Authors: R Rai SK, Dandapat SK, Jadhav D, Jadhav N, Shah A, Rangnekar RD. Journal: Neurol India. 2022 Sep-Oct;70(Supplement):S113-S116. doi: 10.4103/0028-3886.360943. PMID: 36412356