Our Summary

The research paper is about a surgical procedure called decompressive laminectomy, which is often used to treat degenerative lumbar scoliosis (DLS), a condition where the lower spine curves abnormally due to aging. The surgery involves removing part of the vertebra to relieve pressure on the spinal cord or nerves. However, there is a concern that this surgery might cause more instability in the spine.

To investigate this, the researchers looked back at the records of 60 patients with DLS who had this surgery. They divided the patients into two groups: those whose spines remained stable after surgery and those who showed signs of further instability (referred to as post-laminectomy instability or PLI).

Of these patients, about 57% had stable spines after surgery, while 43% showed signs of instability. About 20% of the patients needed additional surgery. They found that 18.3% of the patients showed instability at the exact spot where the surgery was done, while 25% showed instability in other areas of the spine.

They concluded that while further instability can occur after the surgery, it isn’t always directly caused by the surgical procedure itself. However, the instability seemed to develop more quickly where the surgery was performed, compared to other parts of the spine. The survival rate of the patients was 90% one year after surgery and 86.4% two years after surgery.

FAQs

  1. What is decompressive laminectomy and why is it used to treat degenerative lumbar scoliosis?
  2. What percentage of patients experienced post-laminectomy instability after the surgery, according to the research?
  3. Does the surgical procedure of decompressive laminectomy directly cause further instability in the spine?

Doctor’s Tip

A helpful tip a doctor might tell a patient about spinal laminectomy is to follow a strict rehabilitation plan after surgery to strengthen the muscles supporting the spine and improve overall spinal health. This can help reduce the risk of further instability and complications in the future. Additionally, it is important to follow up regularly with your healthcare provider to monitor any changes in spine stability and address any concerns promptly.

Suitable For

Patients who are typically recommended spinal laminectomy are those with degenerative lumbar scoliosis (DLS) who are experiencing symptoms such as back pain, leg pain, numbness, or weakness due to pressure on the spinal cord or nerves. These patients may have tried conservative treatments such as physical therapy or medication without success, and their symptoms are significantly impacting their quality of life. Additionally, patients who have evidence of spinal instability or spinal stenosis may also be recommended for spinal laminectomy to relieve pressure on the spinal cord.

It is important to note that the decision to undergo spinal laminectomy should be made in consultation with a spine specialist, who will consider the patient’s individual case and determine if the benefits of the surgery outweigh the risks. Patients with certain medical conditions or factors that may increase the risk of complications from surgery may not be good candidates for spinal laminectomy.

Timeline

Before spinal laminectomy:

  1. Patient experiences symptoms of degenerative lumbar scoliosis, such as lower back pain, leg pain, numbness, or weakness.
  2. Patient undergoes diagnostic tests, such as X-rays, MRI, or CT scans, to confirm the diagnosis.
  3. Patient and their healthcare team decide that spinal laminectomy is the best treatment option.
  4. Patient undergoes pre-operative assessments and preparation for surgery.

After spinal laminectomy:

  1. Surgery is performed to remove part of the vertebrae to relieve pressure on the spinal cord or nerves.
  2. Patient is monitored in the hospital for a few days post-surgery.
  3. Patient undergoes physical therapy and rehabilitation to regain strength and mobility.
  4. Patient may experience temporary pain and discomfort post-surgery.
  5. Follow-up appointments are scheduled with the healthcare team to monitor recovery and address any concerns.
  6. Patient gradually returns to normal activities and experiences relief from symptoms of degenerative lumbar scoliosis.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a spinal laminectomy surgery?
  2. How long is the recovery process after a spinal laminectomy surgery?
  3. Will I need physical therapy or rehabilitation after the surgery?
  4. What are the chances of developing post-laminectomy instability and how can it be prevented?
  5. Are there any alternative treatments to consider before undergoing a spinal laminectomy?
  6. How long do the benefits of a spinal laminectomy surgery typically last?
  7. What is the success rate of spinal laminectomy surgery for treating degenerative lumbar scoliosis?
  8. Will I need to make any lifestyle changes or modifications after the surgery to prevent further spinal issues?
  9. How often will follow-up appointments be needed after the surgery?
  10. Are there any specific exercises or activities I should avoid after a spinal laminectomy surgery?

Reference

Authors: Ha KY, Kim YH, Kim SI, Park HY, Seo JH. Journal: Clin Orthop Surg. 2020 Dec;12(4):493-502. doi: 10.4055/cios19176. Epub 2020 Nov 18. PMID: 33274027