Laminectomy Surgery Results

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Moldova

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Welcome on board! You in a good place here; you can get a lot of information regarding any type of surgery.
As far as I know and based on information I got from my DR's, research I done - laminectomy surgeries have the highest sucess rate along with discsectomies (sp?) to compare to fusion ones.
SounRAB that your DR is very confident and the most important you have a lot of trust in him - just do what you have to do to feel better.
Patients with this type surgeries usually recovering pretty fast, they go on with their lives, that is why you don't read much here about their sucess stories.
Good luck to you!:angel:
 
Wow....arachnoiditis is scary stuff. Thank you for the information on this condition. It looks like it can result from multiple or complex spine surgeries, as well as chemical injection. The epidural injections have risk and I realize that they are not good to do long term.

Baybreeze....I agree about the exercise ball. I love doing core exercises with the ball. You can also do some spine decompression with the ball as well.

I'm looking forward to meeting with the surgeon again soon and discussing the questions that I have. During my first meeting he clearly showed me on the MRI films where the stenosis is occurring at L4-L5 with bone (not disc). The MRI films are amazing with the detail that they show on what is going on in the spine area.
 
Hi,

I happen to know quite a bit about the x-stop. I found it online several years ago when I was first told I would need surgery. It is new enough that it is not yet commonly used all around the country. I went to a doc at the Univ. Wisconsin medical clinic who was doing clinical research on it and who trains other surgeons in its use. As it turned out, I am not a candidate for it due to my spondylolisthesis. If your doc said you are a candidate, I would definitely look into it...and if it were me, I would be willing to give it a try. To me there are only positives...and it just makes sense to me. If it doesn't work for you, or if it pops out, you can always go back and have a fusion or whatever procedure you need. The implantation of an x-stop does not require the removal of any bone, so you are no worse off for trying it.

The X-Stop is new enough that there isn't any information beyond the 5-year trials...so you are taking a garable...but I felt the garable was small and was worth it!!

Hope this helps. If you have more questions, let me know!!

xx MM
 
Wow...thanks very much for the great feedback....I really appreciate it!!

I'm making a list of questions for this surgeon and I want to schedule another appt with him to discuss.

What are your thoughts/opinions/experience with the following:

1) Will spine surgeons give references or allow a prospective patient to speak with some of his prior surgery patients ?

2) I play golf quite a bit and I noticed that Greg Norman and Peter Jacobsen both had spine surgeries within the past couple of years, and have resumed their golfing careers. They seem to have done well with their surgeries and their back health is obviously critical to them.

3) Is it generally the case that once one has a spine surgery there is a high probability that more surgeries will be needed in the future due to the back being weakened ? Can this be counter balanced through a strong daily core exercise and stretching program ?

4) How big of a problem can scar tissue from surgery be with spinal stenosis ? How is scar tissue from spine surgery addressed ?

5) I think that the surgery this surgeon was discussing with me may have been a micro laminotomy, as he said it would be an out patient procedure of around 1.5 hours, back to work in 2 weeks, and return to normal activity in 6-8 weeks.

6) Does spinal stenosis generally get worse even with an agressive back and core muscle strengthening and stretching program ?

7) I wonder if I'm better off in the long run just staying with the epidural injections and the strengthening and stretching program without the surgery. I've been doing the strengthening and stretching twice a day for about 4 weeks, and it might be my imagination but my lower back seems to be responding positively.
 
Hi John,

1) I think a surgeon should be willing to give references or let you speak to some patients, if they are willing. I was lucky in that, even tho my surgeon was a bit far away, I met a few of his patients by chance in my Physical Therapy. My PT knew some people had their surgeries by the same surgeon I was going to and he asked them if they would come talk to me about it. One woman was soo nice, she even gave me her phone # for support if I needed it. THey gave my surgeon high praises. My PT has also heard alot about him over the yrs, so If you have a PT, definitely ask them who seems to have a good reputation. Also, ask the nurses in the hospital where the surgery will be done. I had nurses tell me I was in good hanRAB & they would use him too.

2) Spine surgery (as with any surgery) is always a risk, but many times its for the better. Not everyone who has surgery enRAB up with more problems or pain. There are many people who have success and maybe never a problem again. There is just no way to predict that.

3) Not necessarily. I really dont know what the percentage might be, though there are many on these boarRAB who've had to have more. I was told, since I had multilevel laminectomies, that it's possible I might need fusion in the future. That is b/c bone was taken away from a major support structure (the spine) and it puts more stress on the surrounding spine joints that are left. This can cause more or worsening of arthritis. That seems to be whats happening to me, though it doesnt mean it would happen to you. I already had spondylosis (spinal OA) and nothing can cure that. So that is with me for life. So if someone already has OA in there, it might be more likely for them to have more problems,just my guess. Also, if you have alot of nerve problems in there or hardware, it seems it might end up causing more pain or problems with each surgery. You should definitely strengthen your core as much as possible, I know it would help with something. If nothing else, it would still help with your posture and activities that you do. I went to PT for about 6 months before I had surgery. I was in alot of pain but I did what I could anyway. I am positive that by doing this, it helped in my recovery AFTER surgery. It probably helped me heal better , etc. I do still go the PT (which has been over a year & 1/2 now) but I keep getting herniations and scar tissue problems. But then I think, if I never did the exercising & strengthening, how much worse might I be???

4)The scar tissue probably depenRAB on how your own body heals, plus how large of an incision and where & what they are cutting. My scar is about 5-6" and of course they had to cut thru all the fat and surrounding muscle. From what my surgeon said, I also had some disc material snipped away also. THe best way to lessen the chance of scar tissue is to follow your post surgery instructions to a Tee!! Dont sit longer than 20 min. at a time. Make sure you walk as much as possible. This cant guarantee you wont get scarring, but I would think if one just sits all day doing nothing, that gives ALOT of time for scar to form and just stay there. If you are moving or carefully stretching (In a way that your PT tells you is ok), it may lessen it. I did exactly what I was told but I have alot of scarring anyway. So it's another thing that one cannot predict.

5) Ohhh, okay...micro laminotomy, if it's outpatient, then is not quite the same a laminectomy. I dont know much about the micro surgery, but that would explain why your doc gave you such a short recouperation time. I guess the tinier the incision & less that has to be removed, the quicker the healing & probably the greated chance of a good recovery.

6) It depenRAB on what stenosis you have , whats causing it. If its from a disc herniation, many times that might resolve on it's own over time. The disc material can just reabsorb into the body. But there are some people who have a herniation for a long time & try everything else, then have surgery.
If you have stenosis from osteophytes and ligament thickening/buckling, then it will never go away. For some it might not worse much, but for others the bone overgrowth will continue until one can no longer walk, which is what happened to me and several other spineys on this board.

7) Do you have surgery date scheduled yet? If you think the strengthening is really seeming to help you, you should probably give that more time then. Usually the EPI's will be able to relieve enough pain to allow you to exercise. How long ago was your last EPI? If it was recent, then that could be why you feel better. If it was a while already, then chances are it's the exercise that's helping.


Hope this helped in some of your questions and feel free to ask more if need be!
 
Hello,

I am a relatively new meraber to the forum. I am starting to research surgery options for my spinal stenosis, and I'm wondering what type of results others in the forum have had with laminectomy surgery for spinal stenosis ?

My situation is a stenosis problem primarily at L4-L5. I have been receiving epidural injections about every three months for the past 2 years with pretty good success. They provide pain relief for a period of 2 - 3 months. Once the injection wears off I have fairly strong nerve pain down the left leg.

I live in the Boston area and met with a surgeon today at New England Baptist Hospital. He was very confident that a laminectomy surgery would relieve my nerve pain, with a short recovery period of 2 weeks to go back to work, and 6 - 8 weeks to resume normal physical activity. He indicated that he does about 50 of these types of surgeries per year.

It seems that from what I have read in the forum, that many have had poor results from surgeries with continued pain. Or it might be that the majority that have had successfuly surgeries don't spend time in back forums after their successful surgery and recovery.

Any thoughts on laminectomy results would be appreciated.

I was also referred by another back doctor to an aggressive back and core exercise and stretching program directed by New England Baptist.

Thanks
DJ
 
MM...thanks for the feedback on X-Stop. I agree it seems very positive...it is less invasive, recovery is much quicker, and from the clinical trials that I have seen the results are as good as, or better than the traditional surgeries. The only potential downside I see is that it is fairly new and there is only about 5 years of historical data on it. Plus it is reversible and the traditional surgeries can still be done later if necessary. I think it is pretty exciting that this procedure is available for stenosis.

The surgeon that I visited with last week in Boston does the X-Stop procedure. I have a follow-up appt with him in a couple of weeks, and I want to explore the X-Stop procedure in more detail with him....including how many he has done, success rates, and patient references that I could talk with. I'll update here in the forum after my appt.

I also started my "Back Boot Camp" physical therapy today which will be helpful for overall spine/lower back health, as long as I keep doing the exercises and stretches daily.
 
You seem like someone who is interested in learning as much as you can about your condition. There are wonderful resources available on the internet.

My fusion was at L4-5 2 weeks ago today...so if you have questions about that area, I might be able to help.
 
Hi DJ!! I think you hit it on the nose. Those that have successful surgeries, do not spend time chatting on the boarRAB. I mean if you were not in pain would you be out with your frienRAB on a Friday night or sitting here chatting on a board???

I had a laminectomy and it helped me for 4 months until I reinjured my back. Many people do fine with this surgery. Just keep in mind that once a spinney always a spinney. Your back is weakened and you need to be extra careful with it for the remainder of your life. Avoid heavy lifting, watch the weight, and strengthen your core muscles once your doctor gives you the go ahead. I would also walk everyday.

Good luck and if you have any specific questions, I would be happy to try and answer them as well as many other merabers on the board.
 
Baybreeze....thanks very much for your comments and insight.

I've been getting the epidural injections about every 3 months for the past 2 years. They have been very helpful with the pain and allowing me to exercise at a gym every day. Working out I can do a good 45 minutes cardio workout and 45 minutes of weight training. One of my questions for the surgeon is whether I would be limited in what I can do at the gym, particularly with weight training.

I start a core / lower back physical therapy program this coming week that goes for about 6 weeks. I want to see how the therapy goes before I schedule the surgery. I've been doing a consistent core strengthening routine twice per day for the past 4 weeks which seems to help. Hopefully I can pick up some additional exercises from the phys therapy sessions to add to my daily routine.

I also plan to meet again with the surgeon to discuss questions and to see if I can get some references from him to speak with. I'd also like to find out from his experience how frequently additional surgeries have been done after the initial one.

Thanks again for the comments and feedback!
 
I had a follow up consultation appt with the back surgeon last week. I had some additional questions to review with him including the x-stop procedure.

On the x-stop, his opinion is that it works better for older individuals who are less active. He felt that the laminotomy (micro-endoscopic laminotomy) would be the best option for me considering age and how active I am. He also is having one of his patients who has gone through a similar surgery, and is around the same age and activity level as me, call me to discuss their experience with the laminotomy surgery. In terms of recovery from the surgery, he again said that the expecation would be that I would be able to go back to work in about 2 weeks, and gradually resume normal activities over 6 - 8 weeks. And back to full throttle golf swings in 3 months.

The interesting thing is that the aggressive lower back stretching and strengthening program (New England Baptist Hospital program) that I have been doing daily seems to helping with my nerve pain and overall back condition. I am nearly 3 months from my last epidural injection and normally by this time I am experiencing significant nerve pain down the left leg. I think my nerve pain has gone from a 5-7 out of 10 to a 1-2 out of 10. Based on what the surgeon has said about expected surgery results, I'm not sure I would do any better than this even with the surgery. By the way, if anyone has access to a multi-hip machine at their gym, I think this is a great machine for lower back rehab and strengthening.....this is one of the machines that I am using for lower back.

My feeling at this point is to not do the surgery and continue with the stretching and exercise program, as I'm not sure that the surgery would improve my condition over how I feel currently with the stretching/exercise program. Of course the situation might change next week or next month with the nerve pain. But it seems to make sense to me to hold off on the surgery for now. I plan to add in pilates exercise to my lower back stretching/exercise program to improve overall flexibility.

On the other hand, the surgery might improve my condition even more as it should relieve the stenosis and resulting inflammation, and the continuing exercise might improve my chances of eliminating future surgery. The surgeon's opinion is that this surgery would not weaken my overall back structure at all.

Please let me know your opinions.

Thanks
 
Ditto to what diet said, but also that that timeframe your doctor gave you, is for the premium patients. Realistic return to work timeframe is 6-12 weeks and resuming normal duties is how one defines normal. Some people get really really lucky and they are the perfect surgery and recovery we wish we all were. While you are not having a fusion done, etc, they would go in there and drill/chisel/hone out bone in your spine and working right at your nerves there, which often causes serious inflammation and that takes a bit to all calm down.

Hopefully your surgery recovery time will occur just as dictated by the doc, but please don't expect it and if it then happens for you.. what a lovely surprise.
 
Hi, if you think youre having that good of a result from the stretching/exercises, maybe you should wait on the surgery. The thing is, though, if thats really helping, you'll probably be best if you keep doing those things all the time, even after your program is over. Like make it part of your regular routine. Otherwise over time, you might end up having that pain back. Surgery is always the last resort and only you yourself will know when you're ready. If you are having doubts now, then go with your gut feelings and see how much your current therapy helps. Theres always risk with surgeries and theres always that possibility you could have more pain after surgery or other complications. If you dont have much pain now, then my opinion would be to hold off on the surgery. Also, if you keep doing those exercises to strenghthen your back, and you do end up getting surgery at some point, the exercising will probably help in your recovery.
 
You need to be careful with the repeated use of the epidural injections. If you enjoy doing research, please check out the word arachnoiditis and read up on this condition. It may give you pause about ever having another esi.

Many doctors will not allow a patient to have more esi's than 3 per year. In many cases, the repeated injection of a steroid into a muscle or ligament will cause that muscle or ligament to eventually break down.

You might want to schedule an appointment with a physiatrist who specializes in the spine. They do everything an ortho or neuro surgeon will do except for performing surgery. They do esi's; they design therapy programs, etc. Or you might want to find a sports orthopedic surgeon who would know your special issues concerning golf.
 
Is anyone familiar with the newer X-Stop procedure for spinal stenosis ?

The surgeon I met with said that the X-Stop procedure would be an option for me. It is a minimally invasive procedure with a quicker recovery time.


Here area a couple of links on the X-Stop procedure:

http://www.stlukes-sf.org/news/enews/0506_xstop.html
 
I totally agree with Baybreeze. In my opinion, surgery is the very last thing you should resort to. You just never know what could happen...nothing intended, of course...and it's really not that helpful talking with another patient because s/he can only talk about his/her own experience. Your experience will be different. Your body is unique...and all the circumstances that will occur at the time of your surgery will be unique. Something as simple as how they have you laying on the operating table could turn out to be the thing that enRAB up causing you unintended nerve pain post surgery. Something completely unplanned...something that isn't even really part of the operation...but it happens.

Since you seem to enjoy working out, I would go with the exercise plan rather than surgery. You can always have surgery...and you'll be in that much better shape if and when you decide to have it. If your nerve pain is now a 1-2, it is really doubtful that post surgery you'd feel any better than that, and you could feel much worse. You are lucky to have found such a wonderful program.
 
I had laminectomies on L3 thru L5 and it was successful in that I no longer have neurogenic claudication and I can walk upright again. However, I still have spinal arthritis and DDD, so keep herniating discs constantly, plus I have alot of scar tissue in there, which has contributed to some pain i've had. The good thing is my bad pain is not constant. THe epidurals help me alot with the nerve pain I get from the herniations or scar tissue issues. But when they wear off, almost my entire spine is soo stiff and achy and I still get some pain in both hip areas when walking or standing for 30 min or more. Thing is now I have worsening facet joint thickening, which is being accelerated by the laminectomies. Since part of the spine is gone, it's causing that much more stress on surrounding bones/joints, and causing more spurring and such. But I knew that could happen before I had surgery.

I am also surprised you were told you could go back to work in 2 weeks!! Of course everyone heals differently, but I was out of work for 10 weeks after mine. Though I have some other issues going on & caused me great fatigue. If not for the other things, I probably would have went back after 8 weeks. Even my surgeon said 6 to 8 weeks is the usual time frame. So if you do have the surgery, I just urge you to be very careful and let your own body tell you when you feel better.
 
Moldova...did you have a laminectomy AND the fusion this time? I know you have had several surgeries. So happy to hear that your latest with Dr. C. went better than the others.

LAF:)
 
The PT will definitely give you different strengthening exercises than what's available to use at the gym. I do alot with the exercise balls to strengthen my abs. It's amazing how many exercises one can do with the ball and how you feel exactly where is being worked. It's not an aerobic workout, but it sure can work your muscles.

As far as asking about being limited in the gym & w/ weight machines, do you mean after surgery or all the time? One thing you can do is ask the physical therapist as they are experts at what one should/can do with what conditions. They will probably have weight training machines in there and can show you what would be best for you. And if you ever have problems with aerobic exercise, the best thing to do for what would be swimming b/c there is no stress on your spine or other joints.

Definitely follow Marlo's advice about the injections & read up on it. Some say not to have more than 3 per year, others say it's okay to have 3 per 6 month period. I dont know which is right. Just do your researach about it, plus about the surgery and keep yourself well informed. I wish you luck with the PT and hope it helps enough so you dont need surgery.
 
Hi Djohn,
I had a laminectomy in June 2007. I would say my actual surgery was a complete success. What I am dealing with is residual nerve pain, not from the surgery, but from the injury which is the cause of my permanent nerve damage. The surgery was not bad at all. There is some pain and discomfort but it wasn't half as bad as the nerve pain I was experiencing! I agree that your surgeon is very optimistic about your return to work! It is VERY easy to re-herniate for several months after your surgery. It's not the pain that will keep you out of work....it is the healing time that is needed. So even though you will feel great, really, really take it easy and give yourself time to heal.
Good luck and keep us posted!

Deb
 
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