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The Hemilaminectomy Procedure
The goal of a hemilaminectomy is to decrease the compression on the nerve root, by decompressing the spine. This is achieved by removing portions of a herniated disc. When the compression is caused by a degenerative disease, a portion is removed on one side of the spine. During the procedure, the patient is under a general anesthetic.
Once the patient has been anesthetized the spinal surgeon makes an incision in the back to expose to the spine. Patient x-rays are referred to, so that the surgeon can pinpoint the discs which are to be removed. Next, the surgeon removes the disc fragments and portions of discs which are causing spinal compression.
Note that a herniated disc is not totally removed, as the complete removal of one or more discs would cause the spine to become unstable. If this were to happen the patient would require a spinal fusion, a procedure which can severely limit mobility. This outcome is avoided whenever possible, by removing only portions of a herniated disc rather than the entire disc.
Patients who undergo a hemilaminectomy are usually able to go home the same day. If a fusion is performed the patient must remain in hospital for three to five days. Most patients will have follow-up visits over the next six to twelve weeks.
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Risks and Complications
After a hemilaminectomy patients should watch for warning signs of infection or other complications. Warning signs include:
- Difficult urination
- Pain in the abdomen
- Leg pain or weakness
- Numbness in the legs
- Back pain
- Infection or swelling in the incision
Following this kind of surgery, it is important for patients to get regular gentle exercise, such as walking and gentle movement. This is because a prolonged period of bed rest can increase the risk of blood clots forming in the legs. However, for most people four to six weeks of rest is needed before going back to work.
Certain types of movement should be avoided, including twisting movements, heavy lifting, and sitting down for prolonged periods.
Most people who undergo a hemilaminectomy will have ongoing discomfort or pain in the back. The pain is usually minor, and can be treated with medication such as anti-inflammatories.
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Alan E. Heilman, MD. Outpatient Lumbar Hemilaminectomy for Lumbar Disc Herniation.