B Lumbar laminectomy or fusion
Lumbar laminectomy is most commonly performed for symptomatic nerve root or spinal cord compression. Compression may occur from protrusion of an intervertebral disk or osteophyte bone into the spinal canal. An intervertebral disk usually herniates at the L4 to L5 or L5 to S1 intervertebral space. A laminectomy procedure involves the complete removal of lamina.
Lumbar fusion is performed when there is instability of the spine. This instability often leads to lower back pain. Bone graft material can be obtained from the patient’s iliac crest or from backbone. Back injuries account for a large percentage of work-related injuries and are a leading cause of work absences.
2. Preoperative assessment and patient preparation
a) History and physical examination: Assess and document neurologic deficits of the lower extremities.
c) Preoperative medication and IV therapy
(2) Consider an antisialagogue because most spinal surgery is performed with the patient in the prone position.