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Laminectomy or Laminotomy

Related Terms

Foraminotomy
Lumbar Laminectomy
Rachiotomy
Spondylotomy

Specialists

Neurosurgeon
Orthopedic (Orthopaedic) Surgeon

Comorbid Conditions

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Factors that may influence length of disability include the extent of the laminectomy or laminotomy procedure; surgical site within the spinal column; underlying cause of the disorder and its severity; procedures performed concurrently with laminectomy, such as discectomy or fusion; occurrence of complications; individual's job requirements; individual's ability to modify work activities; and individual's compliance with treatment and rehabilitation.

The duration of disability is highly variable, depending on whether the root compression is cervical, thoracic, lumbar, or sacral; whether the disorder involves the spinal cord; and whether the individual's job classification is sedentary, light, medium, heavy, or very heavy work. Duration assumes no persisting spinal cord or cauda equina deficit.

Duration Trends from Reference Data

DURATION TRENDS

ICD-9-CM: 03.09

Cases	Mean	Min	Max	No Lost Time	Over 6 Months
441	76	0	240	0.7%	3.4%

Percentile:	5^th	25^th	Median	75^th	95^th
Days:	15	43	66	93	170

Differences may exist between the duration tables and the reference graphs. Duration tables provide expected recovery periods based on the type of work performed by the individual. The reference graphs reflect the actual experience of many individuals across the spectrum of physical conditions, in a variety of industries, and with varying levels of case management. Selected graphs combine multiple codes based on similar means and medians.

Medical Codes

	ICD-9-CM:
	03.0 -	Exploration and Decompression of Spinal Canal Structures
	03.02 -	Reopening of Laminectomy Site
	03.09 -	Exploration and Decompression of Spinal Canal, Other: Decompression: Laminectomy or Laminotomy; Expansile Laminoplasty; Exploration of Spinal Nerve Root; Foraminotomy

Rehabilitation

After laminectomy or laminotomy, individuals wear a low back brace or cervical collar for a period of 2 to 5 months. Individuals undergo inpatient occupational and physical therapy for 3 to 5 days. Treatment focuses on independence in taking the brace off and on. Individuals learn to safely transfer to and from the bed, chair, shower, and toilet.

In the case of lumbar laminectomy, individuals learn to ambulate with a walker and negotiate stairs. Physical therapists instruct individuals to perform abdominal stabilization exercises and leg and arm strengthening exercises.

Occupational therapists teach individuals dressing, toileting, and showering strategies with the use of adaptive equipment as needed to avoid forward bending of the spine.

Outpatient physical therapy begins approximately 1 month after surgery according to the operating physician's protocol. Therapists initially focus on pain control and the reduction of swelling. Modalities such as ice or heat may be used to reduce pain and swelling and decrease muscle spasm.

Increasing range of motion is the second objective of rehabilitation. This is especially important due to the prolonged time that the individual wears a brace. Stretching exercises also maintain the reduction of spasm.

Strengthening the muscles is the third objective of rehabilitation to prevent future injury. Individuals may also perform conditioning exercises such as walking or swimming to increase endurance and strength as tolerated.

Therapy also addresses correct posture, proper body mechanics, and ergonomics. Individuals learn strategies to sit and stand in positions of ease, to reach and lift in a way that protects the back and neck, and to pace activities.

Source: Medical Disability Advisor

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