FAQ's on Aneurysm Surgery

Q- What is Lumbar Decompression?
Ans- Lumbar Decompression
Neuro-anesthesia specialist and internal medicine consultants will pay visit to you and assess fitness with test including blood tests, X- rays and other radiological tests, Dobutamine stress echocardiogram for cardiac fitness and like. Other specialist may also see you on as and when required basis. Blood grouping and typing will be done so as to be ready for blood transfusion if you so need. Blood may be required to be reserved but transfusion will be depend upon the intra-operative blood loss.
Once fit for procedure, a fasting period of 6 hours will be required for anesthesia. Surgery will be done under general anesthesia.
Informed consent will need to be signed so as to permit the surgeon and anesthetist to undertake procedure in good faith. Consent form enumerates the disease process, reasons for undergoing surgery, benefits to expect, risks involved, alternative procedures if any, identifies operating surgeon and needs your informed consent along with a witness signature.
Once in operation theatre, general anesthesia will be introduced by asking you to breathe through a mask. Procedure involves surgery to be done in face down position with a midline skin incision in the back, the incision will be deepened through a avascular plain upto the spinous process of vertebrae, paraspinal muscles will be separated and posterior bony elements will be removed / repositioned so as to create space in the spinal canal thus decompressing the spinal cord and / or nerve roots. Stabilization using rod and screws may be done if instability is encountered. Any abnormal tissue or mass, if encountered will be sent for further tests so as to determine the cause and thus helping in further management. The wound is closed with or without drainage tube, which is subsequently removed next morning. Anesthesia will be reversed in operation theatre and you will come out wide awake.
Breathing exercises and anti-embolic stockings help in healthy recovery. Subsequently with a lumbosacral belt and physiotherapist mobilization will be done. After overnight stay under observation in ICU transit to ward will happen. Discharge from hospital will happen by two three days after surgery. Physiotherapist will assist and teach you maneuvers which are to be continued even after discharge. Stitches may either be self dissolving, subcuticular (buried) or may require to be removed eight days after surgery. Lumbosacral belt needs to be worn for a period of three months, whenever sitting or ambulant.
Check X-Rays will be done on follow up thereafter to confirm bony healing.
Lumar decompression
Although surgery is relatively safe, it dose carries certain associated risks. The incidence of risks this surgery in our hospital are low and are comparable to any other advanced neurosurgical centre.
Surgical complications include but are not restricted to:
Minor Complications :
1.1) Blood collection at the operative site.
1.2) Abnormal sensations or numbness in lower limbs.
1.3) Infection in the wound causing redness or pain. Risk is slightly higher in patients with history of diabetes. Major Complications :
2.1) Injury to the nerve covering (dura with leakage of cerebro-spinal fluid that can cause meningitis and poor wound healing).
2.2) Injury to the spinal cord / nerve root resulting in weakness of legs, impaired sensations, sexual dysfunctions and loss of control of bladder / bowel movements.
2.3) Increase risk in obese people / smoker of wound infection, chest infection, partial lung collapse resulting in post operative breathlessness / difficulty in breathing.
2.4) Highest risk and rate of complications occur in patients who are bed ridden or have no movement in the lower limbs.
2.5) Displacement of adjoining vertebrae to the level of surgery may occur after few years.
2.6) Implant related complications, if used viz. implant loosening, mal-positioning of screws, infection in implant requiring reoperation.
2.7) Rarely blood may clot in the legs (deep vein thrombosis) casing pain and swelling in the calf due to lack of leg movements by the patient or due to weakness in the legs.
Rarely part of this clot may break-off and go to the lungs which can severely affect oxygen exchange and heart function.
After discharge from hospital, for further assistance please contact at following phone numbers:
26825558 / 26925858 or 5801 on ext. no. 2001 and 2012