Laminectomy

Question 1

What is a laminectomy?

Answer 1

Lamina is the bumpy bones along the backbone

Question 2

Why is a laminectomy performed?

Answer 2

to relieve nerve root compression

Question 3

What are the s/s nerve root compression?

Answer 3

1. Pain
2. Paresthesia
3. Paresis (muscle weakness)

Question 4

When you get a laminectomy question what should you pay attention to?

Answer 4

Location

Question 5

Cervical laminectomy
area, impacts, assessment, post op complication

Answer 5

-neck
-impacts the diaphragm and arms
*most important pre op assessment is breathing and function of arm/hands
- post op complication: pneumonia

Question 6

Thoracic laminectomy
area, impacts, and assessment

Answer 6

-upper back
-impacts guts/ abdominal muscles
*most important pre op assessment is cough and bowels
- can’t cough if you can’t contract abdominal muscles
- post op comp: paralytic ileum and pneumonia

Question 7

Lumbar laminectomy
area, impacts, and assessment

Answer 7

• lower back
• impacts bladder and legs
  *most important pre op assessment is urinary retention or last time voided and leg function
  post op comp: urinary retention and leg problems

Question 8

What is the #1 post op technique for laminectomy or any spine surgery?

Answer 8

Log roll

pt bends knees, roll to side, places legs on ground, sits upper body up and then stands

Question 9

Mobilizing after laminectomy or spinal surgery

Answer 9

• Do not dangle pts- no sitting for more than 30 min
• can sit on edge of bed for orthostatic hypotension but thats 5-10 min only
  -They should go from supine to walking asap
• Can stand, walk, lie down without restriction, only restrict sitting

Question 10

Which is the type that requires chest tubes?

Answer 10

they typically don’t but the anterior thoracic does because it goes through front of chest to the back
*pneumo- hemo thorax

Question 11

Laminectomy with fusion

Answer 11

• involves taking bone graft from the iliac crest and spine
  bone from hip taken it put into place to avoid bone on bone

Question 12

Which site requires hemovac or a jp?

Answer 12

hip site

Question 13

Temporary restrictions for spinal surgeries

Answer 13

1. Do not sit for >30 minutes
2. Lie flat, log roll for 6 weeks
3. Don’t drive for 6 weeks
4. Don’t lift more than 5 lbs for 6 weeks (gallon of milk)

Question 14

Permanent restrictions for spinal surgeries

Answer 14

1. Laminectomy patients will never be allowed to lift by bending at waist (use knees)
2. Cervical laminectomy should never be allowed to lift anything over the head
3. No horseback riding, off trail biking, jerky amusement park rides, etc. …