Name of the Procedure:

Laminectomy for Excision of Intraspinal Lesion Other than Neoplasm, Intradural; Thoracic

Summary

A laminectomy for the excision of an intraspinal lesion is a surgical procedure performed to remove non-cancerous abnormal tissue or lesions within the spinal canal in the thoracic (mid-back) region. This surgery involves removing a portion of the vertebra called the lamina to access and excise the lesion.

Purpose

The procedure aims to alleviate symptoms caused by intraspinal lesions, such as pain, numbness, weakness, or impaired function. Removing the lesion can relieve pressure on the spinal cord or nerves, improving patient mobility and quality of life.

Indications

• Persistent back pain.
• Neurological symptoms like numbness or weakness in the legs.
• Difficulty walking or performing daily activities.
• Diagnosis of an intraspinal lesion (e.g., cysts, benign growths) by imaging studies.

Preparation

• Fasting for 6-12 hours before the procedure.
• Adjustments or cessation of certain medications as directed by the doctor.
• Preoperative imaging tests like MRI or CT scans.
• Full medical evaluation and blood tests.

Procedure Description

1. Anesthesia: General anesthesia is administered.
2. Incision: A small incision is made over the targeted thoracic vertebra.
3. Exposure: Muscles and tissues are moved aside to expose the vertebra.
4. Laminectomy: The lamina (bony arch) of the vertebra is removed to access the spinal cord.
5. Lesion Excision: The intraspinal lesion is carefully excised.
6. Closure: The incision is closed with sutures or staples.

Tools and Equipment: Surgical scalpels, retractors, bone rongeurs, and imaging guidance tools.

Duration

The procedure typically lasts 2-4 hours, depending on the complexity of the lesion.

Setting

Performed in a hospital operating room or specialized surgical center.

Personnel

• Neurosurgeon or Orthopedic Spine Surgeon
• Anesthesiologist
• Surgical Nurses
• Surgical Technologist

Risks and Complications

• Infection
• Bleeding
• Spinal fluid leak
• Nerve damage
• Paralysis (rare)
• Blood clots
• Postoperative pain

Benefits

• Relief from chronic pain.
• Improved neurological function.
• Enhanced mobility.
• Prevention of further spinal cord damage.

Recovery

• Hospital stay of 1-3 days post-surgery.
• Pain management with medications.
• Instructions for wound care.
• Limited activity and lifting for several weeks.
• Physical therapy may be recommended.
• Follow-up appointments for checking recovery and removing stitches.

Alternatives

• Conservative treatments like physical therapy, medications, and spinal injections.
• Minimally invasive procedures.
• Observation and monitoring of the lesion with regular imaging.

Patient Experience

During the procedure, patients are under general anesthesia and will not feel pain. After surgery, patients may experience discomfort, manageable with pain relief measures. Gradual improvement in symptoms is expected over several weeks, with full recovery varying from patient to patient.