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January 11, 2011 10:04 AM   Subscribe

My 84 year old mother is undergoing a lumbar laminectomy

My mother is undergoing a lumbar laminectomy in a few weeks. I am trying to discover anything I can about what the recovery process might be like. I have read variances of days to weeks to months. Her doctor has said that she will be able to move from the hospitol after three days to a recovery center.

I understand that the and recovery is based on many issues including whether the procedure is done without spinal fusion. If the spinal column is unstable and fusion is required, there is a recovery period of months to more than a year.

I have placed three calls to the surgeon and have yet to hear back from him or his assistant. I would love any guidance folks here might offer.

Here are the stats:

My mother is 84 years old.
She is in good general health, but she is 84.
The procedure is being done at New England Baptist Hospital in Boston

posted by silsurf to Health & Fitness (6 answers total)
I would question WHY the surgery is needed. The risks of general anesthesia and of surgery itself are not insignificant. The recovery time for an elderly person can be double or triple than that of a 45 year old.

I work with several orthopedists (providing cell saver and PRP services) and see lumbar lamies done all the time. Most of the time I just shake my head because the spine rep is usually in the room too and he's there to tell the surgeon HOW TO USE the instrumentation. As in, some guy with a bachelor degree in underwater basket weaving is telling the surgeon to turn the screw another 1/4 turn or whatever. Scary. The spine rep makes money per case, so he chats up the surgeon, takes him out to dinner, and even arranges for the surgeon to get a consultant's fee/study/paper grant. The whole system of surgery/healthcare is rotten and pretty corrupt.

So, not to say your mom's doc is on the take, but I'd sure as hell want to know the reasoning for doing a lumbar lamie on an 84yr old AND I'd want to knows what has been tried so far and if there are any other options.
posted by PorcineWithMe at 11:19 AM on January 11, 2011

I had a laminectomy at L4-L5 years ago. I was 15. The technique I am sure was different, but the recovery for an otherwise healthy teenager was almost a month before I had my stamina and was pain free. I am not a doctor nor your mother's doctor, but I cringe when I hear that an 84 year old woman is having this operation. I understand your mother must be in great pain, but the risk of the surgery, coupled with the potentially long recovery coupled with her age seems to make this not a great risk/reward.

I also eventually had a spinal fusion some 30 years later and do not think that is an option either. If it were me or my mother, I would attempt to try to alleviate the pain through medication, rehab and altering my physical habits.
posted by AugustWest at 11:38 AM on January 11, 2011

Response by poster: PorcineWithMe,

Thanks for your sobering thoughts. I have had diminished faith and lack of confidence in the medical/hospital system for many years. I agree with your general assessment.

I am afraid my mother is an extremely strong willed and at times impossible person to confer with. Her father was a doctor and there are under lying issues regarding her complete faith in what she is told by the medical industry.

The discussion and debate over this procedure has been going on for more than a year. At one point she had a doctor that thought it was not a very good idea to have laminectomy done, but now it seems they are very positive about the whole thing. They have told her that they believe she has something like a 80% chance of recovery.

I will continue to try to contact the doctor, but also take it as a sign of misgivings that my call is not returned by now.
posted by silsurf at 11:49 AM on January 11, 2011

My 76-year-old stepfather had a lumbar laminectomy done last week. He was home two days later and my mother is having trouble keeping him from doing his harry-homeowner stuff around the house. It's not the invasive surgery it probably was when AugustWest had it done. He's in very good health (heart surgery 1.5 years ago but nothing chronic). Even so, he's 76. Throughout the planning, procedure, and recovery so far, the doc and his office have been quick to return my mother's calls, patient in explaining his options and what he could expect, and just all-around responsive in every way. They even texted my mother throughout the procedure... "he's getting anesthesia now" etc. That communication was really key.
posted by headnsouth at 12:30 PM on January 11, 2011

My grandmother had this done this past December at age 94. Hers was at T12-L1 I think...higher in her back than they expected. She COULD NOT WALK nor barely move due to the pain when we took her to the hospital, although she had feeling in her legs (the doctor was impressed that she had feeling). She was an unusual case because her disk ruptured inward, compressing the spinal column, so her surgery was a near necessity. There was no fusion involved, and the doctor didn't really consider than an option for her because of the increased surgical time and risks involved. She was up walking around the next day, and home the day after that...the surgery cured her pain from the nerves being compressed instantly. However, she was sore at the surgery site and still hasn't built her stamina back up so she keeps a walker nearby just in case (that she has never used before the surgery). She was on IV steroids after the surgery which made her feel great in the hospital, and coming off of those has left her not as "perky", but the doc said that at her age it will just take time for her body to finish healing and get her strength built back up. I noticed that when she was feeling good she'd overdo it and be exhausted the next day, but that's just how she is. Very independent woman.

Obviously YMMV...I tell you this story because not only do I and the doctors involved think she made an amazing recovery (she had her first and only heart attack in her 40's...I tend to think she's one tough cookie) despite her age and the associated risks. However, the surgeon that did the surgery thought about it and consulted with other doctors for about 4 or 5 days before deciding that it was the best course of action. He did X Rays and MRIs and evaluated her range of motion. He also consulted with her orthopedist who's been seeing her for at least 20 years for arthritis, and her cardiologist who's been seeing her for that long as well. Every time he came in the room to talk about the options, I could tell that he was being very thoughtful and thorough and finally came to the conclusion that if she wanted to be able to function again she needed the surgery. He just wasn't going to operate on a 94 year old woman without thinking through everything first, and I love him for that.

So, my advice to you would be to do your best to talk everything over with the surgeon and if you get the feeling he's going to rush into this without considering everything, do your best to get a second opinion. Obviously your mother will have to be cooperative with this, but I think it's important for a surgeon to be thorough instead of just jumping straight to surgery. How much pain is she in? Can she live with that level of pain? Is it getting worse? What happens if the nerves get compressed even more (my grandmother could have lost control of her bladder and bowels if anything shifted or got compressed even more...and that would have required instant surgery)? Would physical therapy/rehab improve her condition without surgery? Why is a fusion an option? Can the fusion be done at a later date? What would make him decide to do the fusion in surgery (vs deciding beforehand)? Has anyone consulted with your mother's other doctors (cardiologist, etc) about the other risks based on her health problems?

Sorry for being so long winded...I was just thinking of all the questions we asked (and the doctor thought of before we did) so that it might give you some ideas of what to consider. Each situation is very different, but you mother may sail through the surgery with no complications, or she may have complications. Best of luck to her and to you!
posted by MultiFaceted at 3:00 PM on January 11, 2011

Response by poster: MultiFaceted,

Thanks very much for your long wind!!

posted by silsurf at 4:21 PM on January 11, 2011

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