63185 Laminectomy with rhizotomy; 1 or 2 segments

Name of the Procedure:

Laminectomy with Rhizotomy; 1 or 2 segments

Summary

Laminectomy with rhizotomy is a surgical procedure involving the removal of part of the vertebra (lamina) to relieve pressure on the spinal cord and nerve roots. It also includes severing specific nerves to alleviate chronic pain.

Purpose

The procedure addresses chronic pain due to nerve compression in the spine, often caused by conditions like herniated discs or spinal stenosis. The goal is to reduce pain, improve mobility, and enhance the quality of life.

Indications

• Persistent back or neck pain not relieved by conservative treatments.
• Symptoms such as numbness, tingling, or muscle weakness.
• Conditions like herniated disc, spinal stenosis, spondylolisthesis, or tumors.
• Patients with significant functional impairment due to pain.

Preparation

• Fasting for at least 8 hours before the procedure.
• Adjustments to medications as advised by the doctor, especially blood thinners.
• Pre-operative imaging (MRI or CT scan) and blood tests.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made in the back over the affected vertebra.
3. The surgeon removes part of the lamina to access the spinal canal.
4. Nerve roots causing pain are identified.
5. Rhizotomy involves severing or destroying these specific nerve roots.
6. Incision is closed with sutures or staples, and a sterile dressing is applied. Tools used include surgical knives, retractors, microscopes, and electrocautery devices.

Duration

Approximately 2 to 4 hours, depending on the complexity and segments involved.

Setting

Usually performed in a hospital or specialized surgical center.

Personnel

• Orthopedic spine surgeon or neurosurgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection
• Bleeding
• Nerve damage causing weakness or numbness
• Spinal fluid leak
• Blood clots
• Persistent pain or recurrence of symptoms

Benefits

• Significant pain relief
• Enhanced mobility and functionality
• Improved quality of life

Recovery

• Initial hospital stay of 1 to 2 days.
• Pain management with prescribed medications.
• Physical therapy to restore mobility and strength.
• Recovery period of 4 to 6 weeks, with limitations on heavy lifting and strenuous activities.
• Follow-up appointments to monitor healing and progress.

Alternatives

• Conservative treatments like physical therapy, medications, and injections.
• Minimally invasive procedures such as spinal injections or radiofrequency ablation.
• Spinal fusion surgery for stabilization.

Patient Experience

The patient will be under anesthesia during the procedure and should not feel pain. Post-operatively, some pain and discomfort at the surgical site are expected, but these are managed with pain relief measures. Physical therapy aids in a smoother recovery.