Spinal laminectomy in Turkey: Process & cost of spinal decompression

Why have a laminectomy?

A laminectomy is a surgical procedure that removes part of the posterior arch of a vertebra to widen the spinal canal. This procedure is generally considered when conservative treatments (medication, physical therapy) do not provide adequate relief.

The most common causes of laminectomy include:

1. Spinal degeneration:

• Spinal stenosis: Narrowing of the spinal canal, often associated with osteoarthritis, which compresses the nerves.
• Herniated disc: Displacement of a portion of the intervertebral disc, which can irritate or pinch nerves.
• Spondylolisthesis: Slipping of one vertebra over another, which can lead to nerve compression.

2. Other causes:

• Spinal tumors: Abnormal growth of cells that pinch the spinal cord or nerves.
• Trauma: Fractures, dislocations, or hematomas that can damage the spine and compress nerve structures.

When should laminectomy be considered?

Laminectomy surgery is generally recommended when:

• Pain, numbness, or muscle weakness persists despite conservative treatment.
• Symptoms are worsening rapidly and significantly affecting quality of life.
• There is a risk of serious neurological complications, such as loss of urinary or bowel control or paralysis.

What factors affect the decision?

The decision to perform a laminectomy is based on several of factors:

• The severity of symptoms: The intensity of the pain, the degree of muscle weakness, and their effect on daily activities.
• The location of the compression: the area of the spine affected and the nerve structures compressed.
• The patient's age and general health: Elderly people or those with other health problems may be at additional risk.
• Medical imaging results: MRI allows precise visualization of the lesion and assessment of the extent of damage.

Preparation for laminectomy

Preparation before laminectomy is critical in ensuring a smooth operation and optimal recovery. It generally includes:

Medical consultation and examinations

A pre-anesthesia consultation is necessary before surgery to assess your general health and select the most appropriate anesthesia.

Additional tests, such as blood tests and an electrocardiogram, may be ordered to complete your medical evaluation.

Information to provide the medical team

Please provide a complete list of all treatments you are taking, including prescription and over-the-counter medicines, nutritional supplements, and vitamins. Some treatments may need to be temporarily stopped before surgery.

Don't forget to mention any allergies (medications, foods, other) and medical history (heart disease, diabetes, respiratory problems, etc.). This information is important to ensure the safety and effectiveness of the procedure.

Preparations at home

Stop smoking several weeks before the procedure to promote healing. Follow your doctor's dietary recommendations.

At home, prepare your environment by asking loved ones for help, installing adaptive equipment such as grab bars, and preparing easy-to-eat meals to help you recover.

How is laminectomy performed in Turkey?

This surgery involves removing a piece of bone (the vertebral lamina) to widen the spinal canal and release pinched nerves.

Before the surgery, you will meet with your anesthesiologist in Turkey to discuss the details of the general anesthesia. On the big day, you'll be welcomed into the operating room, where the medical team will place you comfortably on an operating table.

The surgeon will then make an incision in your back, just above the area to be treated. Using special surgical instruments, the surgeon will remove the part of the bone (the blade) that is compressing the nerve. Other additional procedures, such as removing part of a joint (arthrectomy) or fusing two vertebrae (arthrodesis),may be performed.

Once the goal of the surgery has been achieved, the surgeon closes the incision by suturing the tissues together. A drain may be placed to drain any bleeding.

Postoperative period

A small tube (drain) is inserted to drain the blood and prevent the formation of a hematoma that could compress the nerves. It is usually removed after a few days.

You'll be able to get up the next day with the help of a physical therapist. You may feel dizzy, but this is normal. The physiotherapist will help you to stand up gradually.

After surgery, you will be given pain medication. Further treatment may be necessary. Do not hesitate to inform the nursing team if you have persistent pain.

Your condition will be monitored regularly, especially with regard to healing and sensation in your legs.

Practical advice: 

• Seated position: Choose an elevated sitting position (edge of bed, high chair) to relieve pressure on your back.
• Physical therapy: Physical therapy exercises will help you regain your independence quickly.

You will usually need to take a month off from work. However, it is important to gradually return to your daily activities while taking care of your back.

Common side effects

Bloating and constipation are common after surgery. These discomforts usually go away on their own. If necessary, medication may be prescribed.

Difficulty urinating may also occur in the first few hours after surgery. In this case, a temporary urinary catheter will be inserted.

Risks of complications

All surgery, no matter how routine, carries risks. These risks, although rare, are related to the surgical procedure itself (bleeding, infection, etc.) and may vary from patient to patient.

It's important to note that narrow lumbar canal surgery does not cure all back pain. Even after surgery, you may experience residual pain, especially in the discs or muscles. However, the benefits in terms of pain reduction and improved mobility are often significant.