The nursing care of patients with Decompressive Laminectomy Surgery and Pedicular Screw at Kalasin Hospital.

Abstract

      Objectives of this study were: 1) to implement nursing care for patients undergoing spinal decompression and fixation, and 2) to ensure patient safety and the prevention of complications during hospitalization. Data were collected from the inpatient medical records of patients who received surgical services at Kalasin Hospital between June 2025 and August 2025.  

      Case Study 1: Patient male 60 year old presented at Kalasin Hospital with a chief complaint of low back pain, bilateral leg numbness, and limited spinal mobility (inability to bend or extend normally). Physical examination and MRI revealed severe spinal stenosis with nerve compression at the L4-L5 to L5-S1 levels. The patient was scheduled for surgery on June 12, 2025, for Decompressive Laminectomy (L4-S1) with pedicle screw fixation. The procedure lasted 3 hours with a total blood loss of 1,000 ml; 2 units of Packed Red Cells (PRC) were administered intraoperatively. Due to a smoking history of 6–8 cigarettes per day, the patient developed postoperative atelectasis. On the first postoperative day, the patient experienced severe surgical site pain, which was managed with prescribed analgesics and subsequently improved. Cognitive status and vital signs remained stable. Following physical therapy, the patient was discharged on June 21, 2025, with a total hospital stay of 10 days.

      Case Study 2: Patient female 55 year old presented with chronic low back pain radiating to the posterior thigh. During exacerbations, she experienced severe pain and spinal stiffness. She had previously received analgesics and physical therapy at a community hospital without improvement and was subsequently referred to Kalasin Hospital. MRI findings indicated transverse spinal abnormalities, including facet joint overriding and spondylolisthesis at the L4-L5 level. Surgery was scheduled for August 19, 2025, for Decompressive Laminectomy (L4-L5) with pedicle screw fixation. The procedure lasted 2 hours and 30 minutes with 700 ml of blood loss; 1 unit of PRC was administered. Postoperatively, the patient’s pain was managed according to the treatment plan and gradually subsided. With stable vital signs and cognitive function, she underwent physical therapy and was discharged on August 25, 2025, totaling 7 days of hospitalization.