What Is a Laminectomy?

A laminectomy is a type of back surgery which is used to relieve compression on the spinal cord. During the laminectomy, your surgeon will remove the lamina. Your surgeon will also remove bone spurs. These structures can put pressure on the spinal cord or nerve roots which can cause:

• mild to severe back pain
• weakness in the legs
• difficulty in walking
• difficulty in controlling bladder or bowel movements

A laminectomy is only used if your symptoms interfere with your daily life. It’s performed only 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 usually done to relieve the effects of spinal stenosis. In this situation, your spinal column narrows and puts pressure on the spinal cord. Spinal stenosis can be caused by:

• shrinking of the discs of the spine, swelling of the bones and ligaments, which both occur with aging
• arthritis of the spine, which is more common in older people
• a congenital defect, or defect present at birth, like abnormal growth of the spine
• Paget’s disease of the bones, which is a condition in which bones grow in an improper way
• 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?

Consult with your doctor if you:

• take any prescription or over-the-counter drugs, vitamins, or any kind of supplements
• are pregnant
• are sensitive or allergic to any type of medications, anesthetic agents, tape, or latex

Before performing the surgery, your doctor may ask you to:

• stop taking blood thinners like aspirin
• stop smoking if you’re a regular smoker
• not eat or drink anything 12 hours before the surgery

You should arrange for someone to pick you up and take you home after the surgery completes. You may also need to arrange for someone to help you around the house while your healing is completely done.

How Is a Laminectomy Performed?

A lumbar laminectomy is performed while you’re under anesthesia. If you have general anesthesia, you’ll be asleep during the procedure or you’ll be awake if you have spinal anesthesia. Either way, you will feel no pain during the surgery. Your anesthesiologist will monitor you throughout the procedure.

During the surgery, your surgeon will:

1. clean the skin over the surgical site using an antiseptic solution to help prevent a bacterial infection
2. make a small incision in the middle of your back or neck
3. move your skin, muscles, and ligaments to the side so he can get a better view
4. remove some or all of the lamina bones on your spine
5. remove bone spurs or small disk fragments
6. close the incision using stitches
7. cover the incision using sterile bandages

During the surgery, your surgeon may also perform a spinal fusion, in which two, three or more bones are connected in the back to better stabilize the spine. The surgeon might be performing a foraminotomy to widen the area where the nerve roots go through the spine.

A laminectomy usually takes two to three hours.

What Are the Risks of Laminectomy?

The risks of laminectomy include:

• damage to a spinal nerve
• unsuccessful surgery, which can lead to pain that persists after surgery
• back pain occurs again, particularly after spinal fusion
• an infection in the site where surgery is done
• a cerebrospinal fluid leak because of a tear of the dura mater (a membrane that surrounds the spinal cord)

The general risks of surgery include:

• a blood clot in the legs, which can cause a pulmonary embolism
• 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 surgery 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 two to three days, but this surgery can sometimes be done on an outpatient basis.

While you’re recovering, you should:

• avoid strenuous activity and any kind of heavy lifting
• be careful when climbing stairs
• gradually increase your activities, like walking
• schedule and go to all type of follow-up appointments

While taking a shower, you shouldn’t scrub over the incision site. Don’t apply any type of lotions or creams near the incision. Avoid the use of bathtubs, hot tubs, and swimming pools until your doctor says otherwise. These can all increase the risk of infection.

Your doctor will give you some specific instructions on how to take care of your wound.

Call your doctor immediately if you have any of the following conditions:

• swelling on the incision site or near the incision site
• draining, heat, or some kind of redness at the incision site
• difficulty in breathing
• chest pain
• fever of 101ºF or higher
• tenderness or swelling in the legs
• difficulty in urinating
• a loss of bowel or urinary control

Physical Therapy and Rehab
Physical therapy (PT) may start as early as the day following surgery. PT is a very important part of recovery because it helps the patient build strength, flexibility, and endurance. Many patients are given a home exercise program to continue their progress for the future.

Occupational therapy (OT) is helpful in identifying special needs following your surgery such as the assistive type of devices to help put shoes on or pick up something that has fallen to the floor. Some programs help the patient to problem-solve mechanical deficiency (e.g. dressing). Other aspects of OT would be identifying barriers to returning to the work environment and normal routine. The OT would help simulate the work environment to help the patient resume work and their regular life.

What Is the Long-Term Outlook?

A laminectomy will often relieve almost all symptoms of spinal stenosis. However, it can’t prevent spine problems in the future and it may not completely relieve pain in every patient.

People who also have a spinal fusion are more likely to have other spinal problems in the future.