63272 Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar

Name of the Procedure:

Laminectomy for Excision of Intraspinal Lesion Other Than Neoplasm, Intradural; Lumbar
Commonly known as: Laminectomy, Lumbar Intradural Lesion Excision

Summary

A lumbar laminectomy for excision of an intradural lesion involves removing part of the lumbar vertebra to access and remove a non-cancerous lesion within the spinal canal. This procedure alleviates pressure on the spinal cord and nerves.

Purpose

This procedure addresses issues caused by non-neoplastic intradural lesions, such as cysts or benign tumors, within the lumbar region of the spine. The goal is to relieve symptoms like pain, numbness, or weakness, and to prevent further neurological damage.

Indications

• Persistent lower back pain
• Numbness or weakness in the legs
• Loss of bladder or bowel control
• Diagnostic imaging showing an intradural lesion

Preparation

• Patients may need to fast for 8 hours before the procedure.
• Medications may need to be adjusted, particularly blood thinners.
• Pre-operative diagnostic tests including MRI or CT scans.

Procedure Description

1. Anesthesia: General anesthesia is administered.
2. Incision: A small incision is made in the lower back.
3. Laminectomy: A portion of the lamina (part of the vertebra) is removed.
4. Accessing Lesion: The lesion is exposed by carefully opening the dura mater.
5. Excision: The lesion is carefully excised.
6. Closure: The dura mater is repaired, and the incision is closed.

Tools used: Scalpels, retractors, surgical microscopes, excision instruments.

Duration

Typically takes 2-3 hours.

Setting

Performed in a hospital or surgical center.

Personnel

• Neurosurgeon or orthopedic spine surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technician

Risks and Complications

• Infection
• Bleeding
• Spinal fluid leak
• Nerve damage
• Anesthesia-related risks

Benefits

Patients can expect relief from pain, numbness, and weakness within weeks to months post-surgery, depending on the extent of pre-surgical nerve damage.

Recovery

• Hospital stay of 1-2 days.
• Pain management with medications.
• Avoid heavy lifting or bending for 6 weeks.
• Physical therapy may be recommended.
• Follow-up appointments to monitor recovery.

Alternatives

• Physical therapy
• Pain management (medications, injections)
• Minimally invasive surgeries
• Pros and cons: Less invasive treatments might provide temporary relief but may not address the underlying lesion as effectively.

Patient Experience

Patients are under general anesthesia during the procedure and should not feel pain. Post-surgery, they may experience discomfort managed with pain relief medications. Expected recovery includes reduced symptoms and improved function in the affected areas.