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Laminectomy and Microdiskectomy

Risks and benefits of lumbar laminectomies, hemi-laminectomies and microdiskectomies include numbness, weakness, paralysis, paresthesias, bowel and bladder problems such as incontinence, hemorrhage requiring transfusion, or local hematoma requiring re-operation. There is also a chance of infection or cerebral spinal fluid leak.

All of these complications are unlikely to happen and do so at a rate of less than 1%. The chance of being better after surgery is over 90%. The chance of being worse is less than 1%. The chance of being about the same is up to 5%.

As we do not remove the entire disk, there is a chance of re-herniation that may occur soon after surgery or 10 years later. The chance of this occurring is 5% over 10 years. After a decompression usually the leg pain is better immediately, but occasionally pain may worsen for a few weeks as the swelling subsides.

Lumbar Fusion

Risk and benefits are the same as above, as well as failure to fuse and hardware breakage. Patient's having a lumbar fusion should wear the brace when up and walking for more than 20 minutes. They do not need to wear the brace when driving in a car or sitting. The brace is not needed to walk to the bathroom.

Activity is encouraged (ie long walks with the brace). Stairmaster, treadmill, elliptical machine, bicycling and swimming are all good options. The brace should be worn when up and exercising with the exception of swimming.

The chance of being better after surgery is over 90%. The chance of being worse is less than 1%. The chance of being about the same is up to 5%. Various studies suggest that the risk of adjacent level arthritis after a fusion is 10% greater than the average population over 10-20 years. Most people, however, do very well.

Cervical Surgery

For cervical diskectomies and fusions the chance of numbness, weakness or paralysis is far less than 1%. The chance of hoarseness of voice is less than 5% and the chance of some difficulty swallowing in the short term is 20% and in the long term less than 1%. Most patients notice significant improvement in radicular arm pain immediately after surgery as well as resolution of weakness fairly quickly. Numbness and paresthesias tend to resolve more slowly over several months.

The most common complaint patients have for the first several weeks after surgery is stiffness in the back of the neck, between the shoulder blades, and along the trapezius muscle. This tends to improve with anti-inflammatories and muscle relaxants and usually resolves over a few weeks.

The chance of being better after surgery is over 90%. The chance of being worse is less than 1%. The chance of being about the same is up to 5%. Various studies suggest that the risk of adjacent level arthritis after a fusion is 10% greater than the average population over 10-20 years. Most people, however, do very well.

Patients also may notice the sensation that something is in their throat when they swallow due to the mobilization of the esophagus during surgery and the position of the anterior cervical plate. This tends to improve over several weeks. Regular diet is usually fine.

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