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Lumbar Laminectomy

post #1 of 21
Thread Starter 
I'm fairly new to this forum, so forgive me if I'm premature in starting a new thread. I did a search, but didn't find the answer I'm looking for. Perhaps one of you all can hellp. My husband, my sweetie and best ski partner, is having a lumbar laminectomy and discectomy on Thursday. The neurosurgeon seems quite competent, but they are not especially good about what to do after to get ready to ski. (imagine that! what skewed priorities!!!: )

Anyhow, he's hoping to be back on the hill by Christmas and we'd appreciate any recommendations on a programme to get ready to ski. One of the previous threads mentioned a back brace which his doctor has not mentioned. Is this advisable? We do have access to a PT center/gym nearby and they have "personal trainers" who may be able to help. Still, it's not ski-specific and he needs direction from someone who understands the kind of stress he is expecting to put on his body once again.

BTW, his doctor said that, if all goes well, he shouldn't have to restrict his activities in any way after full recovery which is supposed to be anywhere from 6-12 weeks.

Thank you very much!
post #2 of 21
American sports medicine and Australian seem to have diverged, since the 70s/80s when many Aussie sports medicine doctors went to the US for their training. I notice such big differences in the way conditions are tackled in the US compared with Australia.

Here, before such a procedure, if you were active, you'd already be seeing a physiotherapist, as we always try to manage a condition before resorting to surgery.

After the surgery, you'd usually commence a recovery/rehab programme ASAP with your physio... this is an integral part of any surgery for active people. when I had my shins done, the physio visited me in hospital before the Op, and 2 days after, whereupon we started on rehab.

So you need to hunt down a good sports-orientated physiotherapist, as it's the early stuff that can make such a huge difference. I'm generally against braces (as if you need one, it won't help you!), they are a band aid; good physio treatment works better.

Don't go to the gym trainers as your first port of call. They can be handy to help with your physio programme IF they are properly trained, but if not they can do damage.

I have 2 ruptured discs and arthritis as a result, but they don't bother me at all, as I was lucky enough to have an excellent physio who taught me how to manage the condition, rather than have a spinal fusion. So you see, they can be very valuable.
post #3 of 21
I had this same surgery in Jan. of 99. The surgeon did not recommend any PT for me as I am a personal trainer. He said I would know what to do. You should ask the NS to send your hubby to a PT after your surgery.They will enable him to focus on strengthening his core muscles.
I missed the 98-99 ski season but was back in the mix by the next season. I started teaching in 2001 and have been well enough to attain my L3(pt 1) Mind you that is a lot of bump skiing. I am also able to run 30 miles a week and I still train quite heavily in the gym. I hope your hubby has a successful surgery as I did!
post #4 of 21
Thread Starter 
Wow, thank you! That is truly heartening. We enjoy agressive skiing, so this will help. The PT/gym we go to does focus on core training, so he'll at least follow up there.

Appreciate the advice about the back brace; it rings true.
post #5 of 21
Reactivation of the deep core muscles and restoring proprioception will be the two most important things he can do. This is a detailed article about balance and proprioception exercise:

This article describes its apllications to sport;

Check his posture, and be sure he's not displaying alignment problems as a result of the injury. Be careful of gym pros who only perscribe crunches as core exercise! Good luck!
post #6 of 21
Thread Starter 
Thank you for those links. he will read them while he's stuck horizontal! Your quote is wonderful; if I copy it, do I attribute it to you?

One more thing: The fitness trainer is at a PT place and works w/the them to design his core training programs, so I suspect he's better than your average gym rat guy. I've also had folks recommend a pilates instructor/studio who says he can do rehab. Obviously, to start with, just walking, standing, sitting will be the things to work on, hopefully with a PT's help. But after that, which would you recommend, pilates or core conditioning at the gym??? Thank you. Everyone's been so helpful, on several threads, that I will post my contribution to the forum today.
post #7 of 21
I actually "stole" my quote from Alta Girl, but its been around the net for awhile.

Your question regarding a trainer who specializes in core training or a Pilates instructor is a good, albeit controversial one. I must first confess to bias, as you can see by this article:

Some Pilates instructors believe that the work should be done exactly the way Joe created it in the early 1900s in Germany. While it was a revolutionary system at the time, much research has been done since then. Besides, in the 1900s in Germany, people did not sit at computer desks all day.

Pilates traditionalists believe that the sequence of the exercise should not be altered or modified, even for someone with an injury. They are totally opposed to using the stability ball and othe core related products with their clients.

On the other hand, many progressive, cutting edge trainers have created updated versions of the technique. They may use the baal, bosu or other devices. A personal trainer who specializes in core conditioning may possibly have some Pilates training. It's a good idea to ask. Check out the link to my studio to get an idea of how these concepts can be integrated, and if you have any more questions, please don't hesitate to ask!

post #8 of 21
Thread Starter 
Thank you for your great help, Lisamarie. He had his surgery on Thursday and was home by Friday afternoon, even though they told us he'd be in hospital 3-5 days!!!

He's walking around the block, slowly. Although time will tell, it appears the surgery was a success. He has no radiating pain anymore and, although the new pain is much more severe, he knows it will go away with healing. The surgeon said "it was really ugly in there" so we know he did the right thing by going for it. Major disk degeneration with fragments all over the nerve roots.

He gave his surgery team an incentive by writing a proclamation that he would send a case of good champagne to be split amongts the operating room team after his first successful ski day!

Walking will be his PT for a few weeks, anyhow. After that, I think we'll stick with the trainer at the PT/Gym rather than try a pilates instructor we don't know. The trainer specializes in core conditioning and has had some small amount of pilates training. He regularly uses the ball and bosu, etc. and it is a PT facility, so he can always get help from them too. I'll let you know how it goes. Thanks again for your help. I hope to visit your studio some day.
post #9 of 21
I have had four back injuries and am currently nursing four compressions, the worst in my lumbar, the rest thoracic. Please explain the procedure to me, Mom. My L5 keeps going anterior and I'm kinda curious about what gets done and the long term effects.

I do some balance and proprioception exercise on the ball (I saw what Lisa Marie briefly said about that), but my saving grace has been a spinal tune-up exercise. With all nerves located in the spinal column, I have found the results of exercising the spine amazing, for not only the back, but for the entire body.
post #10 of 21
Is the laminectomy still where they slice some bone off the hip and make a new disc out of it? My L5 is a tattered scrap as well, but so far doing ok, its not getting any help from L4 and its friends either, they are all out late every night and dissipating themselves.
post #11 of 21
Thread Starter 
Well, I've become a self-taught know-it-all over the last two years that my husband has been suffering. He had the Laminectomy Thursday before last and yesterday we went for an hour walk up a forest road in the local mountains. He has lots of pain still from the surgery, but NONE (Yippy) from the original problem, even after walking. He's planning to be skiing by the new year.

So, here's the thing. He had a "traditional" laminectomy, turned out to be a partial laminectomy on L3 and L4, the offending disc being between them. this means removing part of the spinous process - the "fins" you feel when you rub your hand up and down your spine.Sometimes they take out a whole joint. The purpose of doing this is to create space for the spinal chord which was being pressed between the bone and the bad disc on the other side. when the surgeon got in there, he found "a really ugly mess" in that the disc had fragmented and was pushing on all sorts of nerves. So he cleaned it out and made the openings for where the nerve roots exit on either side larger to give them space. It is a big surgery, requiring the large back muscles to be spread apart and that causes a lot of the reason for long healing tiem along with the fascia being cut to give access to the spine.

There is an alternative if all you have is a bulging disc. We looked into this too, but thankfully chose the traditional way because it turned out to be so bad and because his herniation was right in the middle and hard to get to. Still something to consider. There are a few (only a few) surgeons who perform "minimally invasive micro surgery" on the spine via endoscope. One is Microspine in Florida, another is Dr. Chiu in California and some in TX i think. They go in via endoscope using fancy computers and snip out the protruding disc material without having to do all that stuff to the muscles, bone, etc. They say, if it works, you get right up off the table and walk away. Only a couple of days recovery. If your discs aren't that bad. It is worth considering.

My husband's situation was different, and we were also persuaded by the desire not to have to travel to have it done = just in case. It turned out to be the right decision for him. But I wish you 2 the best. back pain is miserable and you want to avoid major surgery if you can.
post #12 of 21
Thread Starter 
PS: feel free to PM me if you want more information. I don't know much more than this, but I'll be happy to help anyone navigate this issue
post #13 of 21
luv ya, mom. tell dad to heal fast.
post #14 of 21
Surgery won't be needed for me, maybe not ever, thanks to some very advanced physiotherapy. i have 2 herniated discs and resultant osteo arthritis up the lumbar and sacroliac region, but the condition is managed, pretty well 99% of the time.
the surgical prognosis for me was a spinal fusion, so I think the managed option is a much better one!
post #15 of 21
Thread Starter 
Dear ant. Yessirrie. fusion is not a good thing - avoid it if you can. When my husband's disc condition was in early stages, accupuncture helped a lot. (and he's not one of those oogegdyboogedy types who normally does in for that sort of thing....) Keep up the physio and best of luck to you!

Oh, and back to ya, SV!
post #16 of 21
Thread Starter 
Just in case anyone is interested/curious because they may be considering this: Three weeks post-surgery and he started his second week full time back at work. Started a program at the gym and is working on skiing by new years at the latest. wound still red and a bit swollen, but not too bad. All continues to go well. he considers it a new lease on life. it's not always that way, but for him, it was a great decision.
post #17 of 21
That's great. Make sure he's taking calcium and E, 3 mg of Boron with the calcium.(if the dr. approves, of course.)
post #18 of 21
Thread Starter 

lesson recommendation

Eight weeks post-surgery. his birthday. Trainer says he's recovering faster than anyone he's seen

Went for a nine-mile walk up through the golden aspen, mixed conifer, open top of the hill. There's a bit of a crisp feel to the evening air and we're looking forward to skiing.

He is understandably nervous. Still gets tired sooner than he used to and is working on balance issues created by having his back muscles so rudely stressed. So he wants to start the season with some lessons to improve skiing efficiency and to get back into it carefully. (i know, skiing carefully is an oxymoron, but there you go.) He is a very good, l'd guess level 8 skier and before the operation favored natural snow, bumps and trees. (IMO his groomed skiing could use some improvement: )

Having had good and awful experiences with lessons, I want to make sure we get the right person or lesson plan. We ski Santa Fe, Taos and have season passes to Winter Park. We were thinking about the Taos locals clinics, but I worry that he needs more one-on-one instruction.

Any recommendations?
post #19 of 21
I would post the question in ski instruction, since I think there are some New Mexico instructors on this forum. I'm not sure, but I think that Rusty Guy is at Winter Park. If you ever get to Copper, there are some spectacular instructors.
post #20 of 21
Thread Starter 
Thanks, Lisamarie, I'll do that.
post #21 of 21
Thread Starter 

Whoo hoo, cleared to ski!

The patient went to the surgeon for his last post-op visit and got his official clearance to ski (although suggested laying off the bumps for a while)

Since there's no snow here, we're heading to Winter Park. I get to WP a little early. Wonderful husband arrives the 21st. The doc suggested lessons becauase of surgical patients tending to be timid when first out. (doc's a skier) We're thinking a half day freeski on the 22nd just to get his ski legs and then lesson(s) on the 23rd, but could be persuaded to start lesson right away.

(He is/was an 'advanced' skier - whatever that is. To give you perspective, his hands-down favorite run used to be Trestle and IMO, he's better at that than he is on the groomed, which is why this'll be good for him)

Anyone here want to take this on? Lisamarie suggested RustyGuy. I also noticed Lenny Blake is a WP guy. Don't know who else might be here who teaches at WP. If one of you can recommend someone who may be available and/or would be good at getting someone back on track post-op, I'd be way grateful.

Hope one of you all can help us; please respond here or feel free to PM me. (has to be WP/MJ because we have season passes and family there.)

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