Physical Therapy in North Aurora, Batavia and Aurora for Lower Back
Welcome to Physical Therapy Advantage's patient resource about Lumbar Laminectomy.
Lumbar laminectomy is a surgical procedure to relieve pressure on the spinal nerves. Degeneration, or wear and tear,in the parts of the spine may narrow the spinal canal. This puts pressure on the nerves in the canal. This condition is called spinal stenosis. A laminectomy involves removing a section of the bony covering over the back of the spinal canal. This takes pressure off the spinal nerves.
This article will help you understand:
why the procedure becomes necessary
what surgeons hope to achieve
what to expect as you recover
Hear from some of our patients who we treated for Back Pain
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Joe and his Team are fabulous, knowledgeable and friendly. I came to this practice following major spinal surgery, and I am so pleased with the care I received. I appreciate the level of expertise and... ”
“ Joe and his Team are fabulous, knowledgeable and friendly. I came to this practice following major spinal surgery, and I am so pleased with the care I received. I appreciate the level of expertise and care at a smaller independently owned clinic. I recommend Physical Therapy Advantage without reservation for your PT needs. Although Joe was my main provider, I had occasion two work with the two other PTs. Both were excellent! You won’t be disappointed if you give Physical Therapy Advantage a call for your needs. They will listen and provide you with excellent care that goes beyond your scheduled sessions. The front desk staff is courteous and respectful, too. This practice is professional, and I’m glad I followed a friend’s recommendation to give it a try! ”
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Joe King and the staff at Physical Therapy Advantage are terrific. After two total hip replacements and spinal decompression surgery, I had been through several Physical Therapy experiences. My most... ”
“ Joe King and the staff at Physical Therapy Advantage are terrific. After two total hip replacements and spinal decompression surgery, I had been through several Physical Therapy experiences. My most recent surgery brought me to Joe and for the first time, I’m confident that Joe’s diagnosis and plan, will put me on the path to pain free independence. I’m grateful to have found Joe and his Team and give them my highest recommendation. ”
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Working with Christine, Joe and the staff at PTA has been a life saver. They have helped me with neck pain from a bulging disk and taught me skills to help strengthen my neck.
I highly recommend... ”
“ Working with Christine, Joe and the staff at PTA has been a life saver. They have helped me with neck pain from a bulging disk and taught me skills to help strengthen my neck.
I highly recommend this facility even if you live outside the North Aurora area...worth the drive. I will definitely recommend their services and use in the future.
Thank you all again for everything over these past several months. Michelene P ”
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I recently had back surgery to decompress a nerve that had been compressed for several years along with addressing some spinal stenosis issues. Once things were sufficiently healed I started working... ”
“ I recently had back surgery to decompress a nerve that had been compressed for several years along with addressing some spinal stenosis issues. Once things were sufficiently healed I started working with the folks at Physical Therapy Advantage. They are an amazing group. They listen to you, adjust their approach as-needed, pay attention to the whole picture, and give clear instruction. I believe that working with them has helped me to heal faster, gain strength without reinjuring myself, and further improved the outcome of the sugery. I would encourage anyone seeking the help of a physical thrapist to give Physical Therapy Advantage a call. ”
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Joe and his staff at Physical Therapy Advantage are fantastic. I’ve been a client twice and had a great experience both times.The first time was due to severe low back pain (with spinal arthritis... ”
“ Joe and his staff at Physical Therapy Advantage are fantastic. I’ve been a client twice and had a great experience both times.The first time was due to severe low back pain (with spinal arthritis and a herniated disc as the primary causes) about five years ago. It had gotten bad enough that I was barely able to crawl, let alone stand up or walk. I saw my primary care doctor and a neurosurgeon and had an epidural steroid injection for the pain before being prescribed physical therapy to see if it helped. It did! Joe was able to figure out what was out of alignment and why, and I was pain-free in a just a few months.I recently had some pain again in my hip and low back and decided to skip the shots and doctor visits and just head straight to physical therapy. I went back to Physical Therapy Advantage since my experience the first time was so good. The second time was just as good - I’m all fixed up just a few months later and have a home stretching and exercise routine to prevent future problems (which I’m about to do after posting this!).Joe is great at diagnosing and explaining exactly what is wrong and how the exercises and stretches he recommends will work to fix it. He and his staff are also positive and friendly. I hope that I won’t have a need for more physical therapy any time soon, but if I ever do, I’ll be seeing Joe again. ”
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Can’t say enough about PTA. The team is very friendly and so encouraging. Joe/ Christine and Greg helped me get relief from from 3 years of low back pain and clearly explained what I needed to do to... ”
“ Can’t say enough about PTA. The team is very friendly and so encouraging. Joe/ Christine and Greg helped me get relief from from 3 years of low back pain and clearly explained what I needed to do to get strong. Their knowledge of therapy services was outstanding. Thank you for making a difference in my life! I would definitely come back here if I ever need PT services again. ”
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After a painful back injury, PTA helped immensely in my recovery! I went from limited strength and range of motion to good as new in just a few weeks! I highly recommend them, and I would go back in a... ”
“ After a painful back injury, PTA helped immensely in my recovery! I went from limited strength and range of motion to good as new in just a few weeks! I highly recommend them, and I would go back in a heartbeat if/when I need help in the future! ”
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I am happy to recommend Physical Therapy Advantage! Joe and his team are competent, professional, and most importantly kind and caring. Joe is very thorough in his evaluation of you and creates a... ”
“ I am happy to recommend Physical Therapy Advantage! Joe and his team are competent, professional, and most importantly kind and caring. Joe is very thorough in his evaluation of you and creates a personalized routine to support your individual needs. He explains the proper techniques to you and watches to make sure you are doing the exercises correctly, offering suggestions if needed. He checks in with you to assess progress and answers any questions or concerns. I was very pleased with my progress working with Joe on some low back issues. I was able to resume activities I had stopped due to discomfort and feel confident that I have some new tools in my toolbox to help me in the future. ”
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Quality. Caring. Professional. Community driven. Physical Therapy Advantage stands as a shining star in the North Aurora area. I previously worked there as an aide and was blown away by the amount of... ”
“ Quality. Caring. Professional. Community driven. Physical Therapy Advantage stands as a shining star in the North Aurora area. I previously worked there as an aide and was blown away by the amount of care and professionalism Joe, Julie, and the Team carried themselves with. Years later I am now returning as a client for my shoulder and low back pain (I wouldn't think of going anywhere else). Julie has been able to relieve me of back pain that I had previously deemed as "something I will have to live with" as well as helped me with the numbness in my fingers. So yes, I would and have recommended Physical Therapy Advantage to anyone and everyone who needs it. ”
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Great experience overall. I went in with lower back nerve pain hoping to find relief knowing that complete and and total relief is not possible. Through targeted stretching to loosen the joints and... ”
“ Great experience overall. I went in with lower back nerve pain hoping to find relief knowing that complete and and total relief is not possible. Through targeted stretching to loosen the joints and muscles involved and exercises design to strength and stabilize the joints and muscles involved, I did find good comprehensive relief for the nerve pain. Joe also provided a good workout plan to maintain the flexibility and strength going forward on my own, it was exactly what I needed. ”
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Joe King and his team are top notch. They are experts at listening and evaluating your area of need. In my case it's knee and hip issues. I walk in with pain in my knee, hip or back and after... ”
“ Joe King and his team are top notch. They are experts at listening and evaluating your area of need. In my case it's knee and hip issues. I walk in with pain in my knee, hip or back and after several appointments, I walk out pain free. For me it's muscle tissue massage along with completing the exercises they recommend. I've always had great results with Physical Therapy Advantage and wouldn't consider going anywhere else. ”
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Joe, Julie and entire staff was very professional courteous and exceeded my expectations for my recovery of a herniated disk. They were always concerned about my pain level and discomfort. I would... ”
“ Joe, Julie and entire staff was very professional courteous and exceeded my expectations for my recovery of a herniated disk. They were always concerned about my pain level and discomfort. I would recommend Physical Therapy Advantage to any one who needs PT. They are the gold standard. ”
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As compared to other physical therapists and their regimen, I rate PTA superior in every respect. The initial evaluation was thorough and informative. But most important was the protocol for each... ”
“ As compared to other physical therapists and their regimen, I rate PTA superior in every respect. The initial evaluation was thorough and informative. But most important was the protocol for each visit beginning with a 30 minute manipulation/massage performed by Joe or Julie followed by 30 minutes of exercises....varying from visit to visit...specifically selected for my current condition and supervised by an aspiring PT assistant qualified to do so. Can't say enough positive about a team that has helped me through back, knee and leg therapies. ”
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I have been in and out of physical therapy going on 10 years now dealing with a combination of inherited genetic spine/joint disorders and arthritic issues. Joe King and his staff have provided me... ”
“ I have been in and out of physical therapy going on 10 years now dealing with a combination of inherited genetic spine/joint disorders and arthritic issues. Joe King and his staff have provided me all these years with exceptional care and quality service. From the in-depth initial evaluation to create a specific personal care plan to each appointment where I am given the opportunity to ask questions, express concerns and discuss my at home progress. Joe and his team listens intently, provides feedback and welcomes input in order to work together with the client as a team to come up with the most beneficial long term plan for the client to help ensure success once they are released from therapy and on their own at home. Such quality care is rare today but you will find it here at Physical Therapy Advantage! ”
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A few years ago, a reputable doctor out of Elmhurst recommend Physical Therapy Advantage (specifically Joe the owner) when I needed physical therapy for my lower back. I’m glad I did therapy instead... ”
“ A few years ago, a reputable doctor out of Elmhurst recommend Physical Therapy Advantage (specifically Joe the owner) when I needed physical therapy for my lower back. I’m glad I did therapy instead of going with the surgical option offered to me at the time. I wouldn’t go to anyone else for physical therapy. I’ve since seen Joe for other physical ailments, which tend to pop up as we age, and I’ve been very happy with those results as well. Joe is extremely knowledgeable and professional and it’s nice to know he’s just around the corner if needed. ”
Surgeons perform lumbar laminectomy surgery through an incision in the low back. The surgery involves the pedicle and lamina bones. These bones attach to the back of the spinal column, forming a bony ring that encloses the spinal canal. Surgeons may remove bone spurs from the facet joints along the back of the spine during the laminectomy procedure, taking pressure off the spinal nerves.
Lumbar laminectomy can alleviate the symptoms of spinal stenosis, a condition in which the spinal nerves become compressed inside the spinal canal. Wear and tear on the spine from aging and from repeated stresses and strains can cause a spinal disc to weaken. The outer rim of the disc bulges outward, and the disc may eventually protrude or even rupture into the spinal canal, narrowing the size of the canal. As a result, the nerves inside the canal are squeezed, leading to symptoms of spinal stenosis.
Degeneration also causes bone spurs to develop. These spurs commonly occur around the facet joints and along the edges of the vertebrae. When these spurs point into the spinal canal, they may squeeze against the spinal nerves. In a laminectomy, the surgeon removes a section of the lamina bone and any bone spurs, taking pressure off the spinal nerves. This enlarges the spinal canal so the spinal nerves have more room.
Preparations
How will I prepare for surgery?
The decision to proceed with surgery must be made jointly by you and your surgeon. You should understand as much about the procedure as possible. If you have concerns or questions, talk to your surgeon.
Once you decide on surgery, your surgeon may suggest a complete physical examination by your regular doctor. This exam helps ensure that you are in the best possible condition to undergo the operation.
On the day of your surgery, you will probably be admitted to the hospital early in the morning. You shouldn't eat or drink anything after midnight the night before.
Surgical Procedure
What happens during the operation?
Patients are given a general anesthesia to put them to sleep during most spine surgeries. As you sleep, your breathing may be assisted with a ventilator. A ventilator is a device that controls and monitors the flow of air to the lungs.
Some surgeons have begun using spinal anesthesia in place of general anesthesia. Spinal anesthesia is injected in the low back into the space around the spinal cord. This numbs the spine and lower limbs. Patients are also given medicine to keep them sedated during the procedure.
This surgery is usually done with the patient kneeling face down in a special frame. The frame supports the patient so the abdomen is relaxed and free of pressure. This position lessens blood loss during surgery and gives the surgeon more room to work.
The surgeon makes a short incision down the middle of the low back. The skin and soft tissues are separated to expose the bones along the back of the spine. An X-ray of the low back ensures the surgeon works on the right vertebra. Some surgeons use a special surgical microscope during surgery to magnify the area they'll be working on.
In a complete laminectomy, the spinous process (the bony projection off the back of the vertebra) and the lamina on each side are removed over the area where stenosis is occurring. To accomplish this, the surgeon cuts along the inside edge of the facet joint on each side and detaches the lamina bone completely from the pedicle bones. This opens a section in the bony ring. A small portion of the ligamentum flavum is removed. The ligamentum flavum runs all the way down the spinal canal between the lamina bones and the spinal cord. Removing a small section of this ligament exposes the nerves inside the spinal canal.
The surgeon may use small cutting instruments to carefully remove soft tissues near the spinal nerves. Then the surgeon takes out any disc fragments and scrapes off nearby bone spurs. In this way, the nerves inside the spinal canal are relieved of additional tension and pressure. The surgeon also enlarges the neural foramina, if needed. The neural foramina are the small openings between the vertebrae where the nerves travel out of the spinal canal.
The muscles and soft tissues are put back in place, and the skin is stitched together.
Complications
What might go wrong?
As with all major surgical procedures, complications can occur. Some of the most common complications following lumbar laminectomy include
problems with anesthesia
thrombophlebitis
infection
nerve damage
segmental instability
ongoing pain
This is not intended to be a complete list of the possible complications.
Problems with Anesthesia
Problems can arise when the anesthesia given during surgery causes a reaction with other drugs the patient is taking. In rare cases, a patient may have problems with the anesthesia itself. In addition, anesthesia can affect lung function because the lungs don't expand as well while a person is under anesthesia. Be sure to discuss the risks and your concerns with your anesthesiologist.
Thrombophlebitis (Blood Clots)
Thrombophlebitis, sometimes called deep venous thrombosis (DVT), can occur after any operation. It occurs when the blood in the large veins of the leg forms blood clots. This may cause the leg to swell and become warm to the touch and painful. If the blood clots in the veins break apart, they can travel to the lung, where they lodge in the capillaries and cut off the blood supply to a portion of the lung. This is called a pulmonary embolism. (Pulmonary means lung, and embolism refers to a fragment of something traveling through the vascular system.) Most surgeons take preventing DVT very seriously. There are many ways to reduce the risk of DVT, but probably the most effective is getting you moving as soon as possible. Two other commonly used preventative measures include
pressure stockings to keep the blood in the legs moving
medications that thin the blood and prevent blood clots from forming
Infection
Infection following spine surgery is rare but can be a very serious complication. Some infections may show up early, even before you leave the hospital. Infections on the skin's surface usually go away with antibiotics. Deeper infections that spread into the bones and soft tissues of the spine are harder to treat. They may require additional surgery to treat the infected portion of the spine.
Nerve Damage
Any surgery that is done near the spinal canal can potentially cause injury to the spinal cord or spinal nerves. Injury can occur from bumping or cutting the nerve tissue with a surgical instrument, from swelling around the nerve, or from the formation of scar tissue. An injury to the spinal cord or spinal nerves can cause muscle weakness and a loss of sensation to the areas supplied by the nerve.
Segmental Instability
Laminectomy surgery can cause the spinal segment to loosen, making it unstable. Each spinal segment includes two vertebrae separated by an intervertebral disc, the nerves that leave the spinal cord at that level, and the small facet joints that link each level of the spinal column.
The facet joints on the back of the spine normally give enough stability, even when the lamina is taken off. This is why surgeons prefer not to remove the facet joints. But these joints may have to be removed if they are enlarged with arthritis or are pushing on the spinal nerves, as explained earlier. When the facet joints must be removed, additional surgery (a fusion) may be needed to fix the loose segment.
Many patients get nearly complete relief of symptoms from the lumbar laminectomy procedure. As with any surgery, however, you should expect some pain afterward. If the pain continues or becomes unbearable, talk to your surgeon about treatments that can help control your pain.
After Surgery
What happens after surgery?
Patients are usually able to get out of bed within a few hours after surgery. However, you will be instructed to move your back only carefully and comfortably. Patients are able to return home when their medical condition is stable.
Most patients leave the hospital the day after surgery. They are safe to drive within a week or two. People generally get back to light work by four weeks. Heavier work and sports should wait two to three months. Workers whose jobs involve strenuous manual labor may be counseled to consider different work.
Outpatient Physical Therapy usually starts four to six weeks after surgery.
Our Rehabilitation
What should I expect as I recover?
Although the time required for recovery is different for each patient, at Physical Therapy Advantage, outpatient Physical Therapy usually begins within six weeks after surgery. As a general rule, Physical Therapy after lumbar laminectomy is generally only needed for a total of four to six weeks. You should expect full recovery to take up to four months.
At first, our treatments are used to help control pain and inflammation. Ice and electrical stimulation treatments are commonly used to help with these goals. Our Physical Therapist may also use massage and other hands-on techniques to ease muscle spasm and pain.
Your Physical Therapist at Physical Therapy Advantage will then slowly add active treatments. These include exercises for improving heart and lung function. Walking and swimming are ideal cardiovascular exercises after lumbar laminectomy surgery. We also teach patients specific exercises to help tone and control the muscles that stabilize the low back.
Our Physical Therapist will also work with you on how to move properly and perform certain activities. This form of treatment, called body mechanics, is used to help you develop new movement habits. This type of training helps you keep your back in safe positions as you go about your work and daily activities. At first, this may be as simple as helping you learn how to move safely and easily in and out of bed, how to get dressed and undressed, and how to do some of your routine activities. Then we will instruct you on how to keep your back safe while you lift and carry items and as you begin more challenging activities.
As your condition improves, your Physical Therapist tailors your program to help prepare you to go back to work. Some patients are not able to go back to a previous job that required strenuous tasks. We may suggest changes in job tasks that enable you to go back to your previous employer. Our therapist can also suggest alternate forms of work. We will teach you how to do your tasks in ways that keep your back safe and free of extra strain.
Before your Physical Therapy sessions end, our Physical Therapist will teach you a number of ways to avoid future problems.
Physical Therapy Advantage provides services for Physical Therapy in North Aurora, Batavia and Aurora.
What do doctors hope to achieve?
Some surgeons have begun using spinal anesthesia in place of general anesthesia. Spinal anesthesia is injected in the low back into the space around the spinal cord. This numbs the spine and lower limbs. Patients are also given medicine to keep them sedated during the procedure.
Nerve Damage