Laminectomy

Question 1

Define Laminectomy

Answer 1

Lamine = Vertebrae Spinous Processess
Ectomy = Removal of

Question 2

What are the Vertebrae Spinous Processes’s?

Answer 2

Bumpy boney wingy thingy on your back.
Wingy part gets removed to relieve root compression b/c if they come out it causes calcium herniated disk, inflammatroy pressing on them, so bone is cut away to give nerve more room.

Question 3

What are the signs and symptoms of nerve root compression?

Answer 3

The 3 P’s

1. Pain
2. Paresthesia (numb and tingling)
3. Paruresis ( muscle weakness)

Question 4

What is the most important thing to pay attention to in any neuro question?

Answer 4

LOCATION

Location of the problem determines symptoms, prognosis and treatment.

Question 5

There are 3 locations of a Laminectomy whats are they?

Answer 5

Thoracic - Upper back - Cough and Bowels

Lumbar - Lower back - Legs and Bladder

Cervical - Neck - Diaphragm and Arms

Question 6

Whats the # 1 answer for Post-OP Laminectomy

Answer 6

1 answer = Log Roll

Question 7

What are 3 interventions the nurse must consider when mobilizing a Laminectomy Patient.

Answer 7

1. DO NOT DANGLE - go from laying down to standing can sit long enough to over come orthostatic hypertension.
2. DO NOT SIT FOR LONGER THAN 30 MIN - up for meals is ok.
3. They walk, stand lay down without restriction. Only restriction is sitting.

Question 8

Describe post- op complications for the 3 Laminectomy locations.

Answer 8

1. After Cervicle - pt. will have difficulty breathing so # 1 complication will be pneumonia. ( Diaphragm and Arms)
2. After Thoracic - pt. not able to cough, so risk for pneumonia, and illeus, bowels won’t work. ( Cough and Bowels)
3. After Lumber - Urinary Rentention or leg problems.

Note: Anterior Thorasic - pneumohemothorax requires a chest tube

Question 9

Describe a Laminectomy with Fusion

Answer 9

• bone graft iliac crest
• Have to fuse so you don’t have bone on bone
• 2 incisions hip and spine - trying to do away with hip incision for its risk of infection and longer recovery time.

Question 10

Describe the 4 temporary restrictions for discharge teaching for Laminectomy with Fusion

Answer 10

1. Do not sit for longer than 30 mins = 6 wks
2. Lie flat and long roll for 6wks
3. No driving for 6 wks
4. Do not lift > 5lbs for 6 wks (gallon of milk)

Question 11

Describe the 3 permenent restrictions for discharge teaching for Laminectomy with Fusion

Answer 11

1. Never lift objects by bending at waist must lift at the knees.
2. Cervical lames are not allowed to lift anything over there head.
3. No off train biking, horse riding, rollercoasters etc.

Note: Use the rules for for Laminectomy for any spinal cord answers.