What Is a Laminectomy?
A laminectomy is a type of back surgery used to relieve
compression on the spinal cord. During the procedure, your doctor will remove the
lamina. The lamina is part of the bone that forms the vertebral arch in the
spine. Your doctor will also remove bone spurs. These structures can put
pressure on the spinal cord or nerve roots. This can cause:
- mild to severe back pain
- numbness or weakness in the legs
- difficulty walking
- difficulty controlling bladder or bowel
A laminectomy is only used if your symptoms interfere with daily
life. It’s performed when less invasive treatments have failed.
This surgery is also called:
- lumbar laminectomy
- cervical laminectomy
- decompressive laminectomy
Why Is a Laminectomy Performed?
A laminectomy is often done to relieve the effects of spinal
stenosis. In this condition, your spinal column narrows and puts pressure on
the spinal cord or nerves. Spinal stenosis may be caused by:
- shrinking of the discs of the spine and swelling
of the bones and ligaments, which both occur with aging
- arthritis of the spine, which is more common in
- a congenital defect, or defect present at birth,
such as abnormal growth of the spine
- Paget’s disease of the bones, which is a
condition in which bones grow improperly
- achondroplasia, which is a type of dwarfism
- a tumor in the spine
- a traumatic injury
- a herniated or slipped disc
How Do I Prepare for a Laminectomy?
Tell your doctor if you:
- take any prescription or over-the-counter drugs,
vitamins, or supplements
- are pregnant or think you may be pregnant
- are sensitive or allergic to any medications,
anesthetic agents, tape, or latex
Before the surgery, your doctor may ask you to:
- stop taking blood thinners, such as aspirin
- stop smoking if you’re a smoker
- not eat or drink anything after midnight the
evening before the surgery
You should arrange for someone to pick you up and take you home
after the surgery. You may also need to arrange for someone to help you around
the house while you heal.
How Is a Laminectomy Performed?
A laminectomy is performed while you’re under anesthesia. You’ll
be asleep during the procedure if you have general anesthesia or you’ll be
awake if you have spinal anesthesia. Either way, you will feel no pain during
the procedure. Your anesthesiologist will monitor you throughout the surgery.
During the surgery, your surgeon will:
- clean the skin over the surgical site with an
antiseptic solution to help prevent a bacterial infection
- make a small incision, or cut, in the middle of
your back or neck
- move your skin, muscles, and ligaments to the
side to get a better view
- remove part or all of the lamina bones on your
- remove bone spurs or small disk fragments
- close the incision with stitches
- cover the incision with sterile bandages
During the procedure, your surgeon may also perform a spinal fusion, in which two or more
bones are connected in the back to better stabilize the spine. Your surgeon may
also perform a foraminotomy to widen
the area where the nerve roots go through the spine.
A laminectomy usually takes one to three hours.
What Are the Risks of Laminectomy?
The risks of spine surgery include:
- damage to a spinal nerve
- unsuccessful treatment, which can lead to pain
that persists after surgery
- a return of back pain, particularly after spinal
- an infection in the surgical site or vertebral
- a cerebrospinal fluid leak because of a tear of
the dura mater, which is the membrane that surrounds the spinal cord
The general risks of surgery include:
- a blood clot in the legs, which can lead to a pulmonary
- breathing difficulties
- an infection
- blood loss
- a heart attack
- a stroke
- a reaction to medication
What Happens After a Laminectomy?
When you wake up after surgery, your doctor will probably ask you
to get up and walk around a bit (unless you had a spinal fusion). You’ll
probably stay in the hospital for one to three days, but this procedure can sometimes
be done on an outpatient basis.
While you’re recovering, you should:
- avoid strenuous activity and heavy lifting
- be careful when climbing stairs
- gradually increase your activities, such as
- schedule and go to all follow-up appointments
While showering, you shouldn’t scrub over the incision site. Don’t
apply any lotions or creams near the incision. Avoid bathtubs, hot tubs, and
swimming pools until your doctor says otherwise. These can all increase your
risk of infection.
Your doctor will give you specific instructions on how to take
care of your wound.
Call your doctor immediately if you have any of the following:
- swelling on or near the incision site
- draining, heat, or redness at the incision site
- difficulty breathing
- chest pain
- a fever of 100ºF or higher
- tenderness or swelling in the legs
- difficulty urinating
- a loss of bowel or urinary control
What Is the Long-Term Outlook?
A laminectomy will often relieve many symptoms of spinal
stenosis. However, it can’t prevent spine problems in the future and it may not
completely relieve pain in everyone.
People who also have a spinal fusion are more likely to have
spinal problems in the future.