Laminectomy, Spinal Decompression and Fusion in Surat

Surgery is considered when something presses on the nerves or cord and the symptoms match the scan:

• Lumbar canal stenosis (narrowed lower back canal): leg pain or heaviness on walking that eases on sitting.
• A disc or bone spur pressing on a nerve: arm or leg pain, numbness or weakness.
• Pressure on the spinal cord in the neck (cervical myelopathy): clumsy hands or an unsteady walk. This tends to progress, and it needs a surgical opinion rather than waiting.
• Cauda equina syndrome: loss of bladder or bowel control with numbness between the legs. This is an emergency.

Except for worsening weakness or pressure on the cord, surgery comes after assessment, scans and a trial of non-surgical care. The slip disc and sciatica guide covers what is tried first.

Spinal fusion joins two or more vertebrae so that they heal into one solid block. Screws and rods hold the spine steady while a bone graft helps the bones unite over months. It is added to decompression when removing bone could leave the spine unstable, for example with a slipped vertebra (spondylolisthesis), a deformity or an unstable fracture.

Many decompressions need no fusion. Fusion reduces movement at the joined levels, and the levels next to it carry extra load over the years, so it is advised only where the benefit is clear.

Most spine operations are done under general anaesthesia. For the back, the patient lies face down, a cut is made over the affected level, the muscles are moved aside, and bone and ligament are removed to release the nerves. For a fusion, screws are placed under X-ray guidance, rods are fixed to them and bone graft is laid along the spine. Depending on the operation, an operating microscope, navigation to guide screw placement and nerve monitoring during surgery may be used.

Before surgery you will have an MRI, often a CT or X-rays, blood tests and a heart and chest check. Tell the team about blood thinners and diabetes medicines, and stop smoking, which slows fusion healing. Keyhole options are described on the endoscopic spine surgery page.

Go to a hospital emergency department the same day, without waiting for an OPD visit, if you have:

• loss of control of urine or stool, or being unable to pass urine;
• numbness around the genitals, anus or inner thighs, or a new change in sexual function;
• leg weakness or a dropping foot that is getting worse, or weakness or numbness in both legs;
• clumsy hands, difficulty with buttons or an unsteady walk;
• neck or back pain after a fall or accident, especially with numbness or weakness;
• severe back pain with fever.

For back pain with unexplained weight loss or a past history of cancer, see a doctor within a day or two. For back, neck or leg pain not improving after about six weeks, book an OPD consultation.