Laminectomy: Surgery for Back Pain
A laminectomy is a surgical procedure to relieve pressure on the nerve roots by removing the lamina, the flattened segments at the back of the vertebral arch. The vertebral arch is the ring of bone that joins the vertebral body to surround the spinal cord.
Why is laminectomy done?
There are two main causes of pressure on the spinal cord or nerve roots:
- Disk herniation occurs when the inner material leaks out of a weakened or damaged intervertebral disk, pressing on and irritating the spinal cord and nerve roots.
- Stenosis refers to the narrowing of the spinal canal, often due to the degenerative changes that occur with aging. As the canal narrows, it crowds the nerve roots and spinal cord that pass through it.
Pressure on the spinal cord and nerve roots can cause pain and numbness or tingling in the arms and legs. Pressure on the nerve roots in the lower (lumbar) back can lead to trouble walking and rarely, to problems with bowel and bladder function.
When the symptoms become severe or if they are not relieved by conservative treatments, such as medication and exercise, surgery to remove the lamina may be recommended. Other procedures, such as a discectomy (removal of a disk) and fusion of the vertebrae, may be done along with a laminectomy.
What happens during laminectomy?
General anesthesia, which puts you to sleep, or spinal anaesthesia is used. For lumbar laminectomy surgery, you will lie face down or be placed in a kneeling position. The surgeon will make an incision in your lower back and separate the muscles to access the lamina. Part of one or more vertebrae will be removed to reach the affected nerve roots. The surgeon will then remove the lamina and any bony growths or ruptured disc material to relieve the pressure on the nerves and spinal cord. The surgery takes about one to two hours.
What happens after laminectomy?
You will be given medication to keep pain under control. You will get out of bed and begin walking the day after your surgery, pain permitting. A physical therapist will teach you how to get out of bed and positions for sitting, standing, and sleeping.
What is the timeline for recovery?
You may go home the same day or stay over night. You should gradually increase your activity when you get home. You will be asked to avoid repetitive bending or twisting and to limit lifting. Your level of activity depends on the extent of your surgery and your general health.
How effective is laminectomy?
Most patients, about 70% to 80%, will experience significant relief of symptoms and improvement in function following laminectomy. Surgery will not correct the underlying degenerative changes in the vertebrae, however, so your symptoms may recur.
What are the risks and complications of laminectomy?
Possible complications of laminectomy include:
- Blood clots
- Nerve damage
- Spinal fluid leak
- Bowel or bladder incontinence
- Worsening of back pain
After the surgery, what symptoms should prompt a call to the doctor?
If you develop any of these symptoms after your surgery, please call your surgeon’s office:
- Opening of incision area; increased redness, swelling, pain, bumps or pimples, drainage or foul odor at the incision site
- A high or persistent fever greater than 101º Fahrenheit
- Difficulty breathing or swallowing
- Increased tenderness or severe pain at the incision site or in the chest, shoulder or abdomen
- Leg swelling or tenderness
- Inability to urinate
- Loss of control of bladder or bowels
- American Academy of Orthopaedic Surgeons. Lumbar Spinal Stenosis Accessed 1/20/2014.
- Better Health Channel (State Government of Victoria). Laminectomy Accessed 1/20/2014.
- Overdevest GM, Jacobs W, Vleggeert-Lankamp C, Thomé C, Gunzburg R, Peul W. Effectiveness of posterior decompression techniques compared to conventional laminectomy for lumbar stenosis (Protocol). Cochrane Database of Systematic Reviews 2012, Issue 9. Art. No.: CD010036. DOI: 10.1002/14651858.CD010036. Accessed via onlinelibrary.wiley.com Accessed 1/20/2014.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 12/6/2013…#10895