Laminectomy

What is a laminectomy?

A laminectomy is surgery on your spine to remove the lamina. The lamina, or “bony arch,” protects and supports the back part of your spinal cord on your vertebrae. Removing the lamina relieves pressure on your nerves and spinal cord by making more room in your spinal canal (the tunnel that holds your spinal cord).

A surgeon usually performs a laminectomy in the lower spine (lumbar laminectomy) to address conditions that cause nerve pain. But this procedure can help treat pain in your neck (cervical laminectomy) or the middle of your back (thoracic laminectomy), too.

What does a laminectomy treat or manage?

A laminectomy treats the following conditions by decompressing or reducing pressure on your nerves:

• Arthritis.
• Bone fracture.
• Bone spurs.
• Degenerative back conditions.
• Herniated disk.
• Spinal stenosis.
• Spinal tumors or abscesses.

Your surgeon might recommend this procedure if you experience:

• Neck, shoulder or back pain.
• Weakness or numbness in your arms and legs.
• Bowel or bladder problems.

Surgery could be an option if your symptoms don’t get better with medications or other types of treatment.

Sometimes a laminectomy is the first part of a two-step surgery with a diskectomy, foraminotomy or spinal fusion.

Does a laminectomy treat spinal stenosis?

Yes, your healthcare provider may consider a laminectomy surgery to treat spinal stenosis. Stenosis in the lower back (lumbar spinal stenosis) is a common cause of low back pain.

Stenosis is the gradual narrowing of the spinal canal. The narrowing space crowds nerve roots and your spinal cord. This may cause severe pain or make it difficult to move. Lumbar spinal stenosis may also limit the distance you can walk due to weakness and leg pain. Spinal stenosis often happens as your body ages, when tissues in your spine slowly wear down.

Can a laminectomy treat a herniated disk?

Yes, spine surgeons commonly perform a laminectomy to treat a herniated disk.

Intervertebral disks are soft, flexible cushions between your back bones (vertebrae). These are the shock absorbers for your spine. A herniated disk happens when the soft inner portion of the disk pushes outside its fibrous external covering. The disc material can then rub against a spinal nerve or your spinal cord and cause pain.

How common is a laminectomy?

A laminectomy surgery is a common type of spine surgery, and it’s one of the most common types of surgery to treat spinal stenosis.

How should I prepare for a laminectomy?

You’ll meet with your surgeon before a laminectomy procedure. They’ll examine you to learn more about your symptoms and previous treatment history. They’ll also order an imaging test of your spine, like:

• An X-ray.
• An MRI (magnetic resonance imaging).
• A myelogram.

Before the procedure, let your healthcare provider know about any medications or supplements you currently take and if you use tobacco products. Your surgeon may recommend you stop taking certain medications or supplements or add a new medication to prevent complications from surgery. Don’t stop taking any medications unless your healthcare provider approves it.

Tobacco products containing nicotine can change the way your body heals or lead to complications, so your provider will suggest cutting back or quitting before surgery.

Your surgeon will also give you specific instructions to help you prepare. These instructions may include contacting someone to drive you home after surgery or asking someone for help to complete routine tasks as you heal since you’ll need plenty of rest.

What happens during a laminectomy?

On the day of your surgery, an anesthesiologist will give you general anesthesia. You’ll be asleep for the entire procedure and won’t feel any pain. You’ll lie face down on special pads to protect the front of your body while your surgeon works on your spine.

To perform a laminectomy, your surgeon will:

1. Make an incision (cut) in your back or neck.
2. Separate or move your skin, ligaments and muscles to the side to access your spine.
3. Use a surgical microscope to get a close look at the bone or area of your affected spine (if necessary).
4. Remove all or part of your lamina, also any disk fragments, bone spurs or affected soft tissue.
5. Perform a foraminotomy (widen a spinal opening for nerve roots) or a spinal fusion procedure (stabilize the bones in your spine) if necessary.
6. Move your muscles, ligaments and skin back in place.
7. Sew or stitch your skin closed around the incision site.

How long does a laminectomy take?

A laminectomy surgery usually takes one to three hours. It may take longer if it’s part of a more complex procedure.

What can I expect after a laminectomy?

After your surgery, you’ll move to an area of the hospital for observation as your anesthetic wears off. Your healthcare provider will give you medication to manage any pain or discomfort you feel.

Your provider will also give you specific instructions on caring for yourself and explain what to look out for if you have any complications. This could include when and how you should get out of bed and start moving after surgery, what activities are safe and what you should avoid.

You’ll likely meet with a physical therapist, who will teach you how to move around safely as your body heals.

Can I go home the same day after a laminectomy procedure?

After a laminectomy, you may go home the same day of surgery or stay in the hospital for one to two days (if part of a larger procedure, your hospital stay may be longer). Surgeons can perform laminectomy using large incisions (open surgery) or small incisions with specialized tools (minimally invasive spine surgery). If your provider uses less-invasive techniques to perform laminectomy, you may go home sooner.

What are the benefits of a laminectomy?

A laminectomy can relieve pain or other symptoms caused by conditions that affect your nerves and spinal column. There’s an option for a minimally invasive form of laminectomy to reduce your recovery time and help you feel better sooner.

How successful is a laminectomy?

A laminectomy has a success rate of 90%. Approximately 75% of people who undergo the surgery are satisfied with the results.

What are the risks of a laminectomy?

Possible risks or complications of a laminectomy include:

• Infection.
• Nerve damage.
• Little to no pain relief after surgery.
• Back pain returns in the future.
• Bleeding.
• Headaches.
• Bowel or bladder problems (incontinence).
• Blood clots.

If you underwent a laminectomy with spinal fusion, you may be more at risk of future spine problems with the possibility of additional surgeries. This surgery may not cure or correct the underlying cause of your pain in some cases — for example, spinal tissues wearing down gradually. For that reason, your symptoms may come back.

Your surgeon will discuss these risks with you before your surgery so you can make an informed decision about your health.

What is the recovery time for a laminectomy?

Your recovery time varies based on what your surgeon needs to do during surgery. You may recover fully within four to six weeks after a minimally invasive laminectomy. If you underwent a laminectomy with spinal fusion, it could take six months to heal completely.

Everyone recovers at a different pace. Rest and take it slow in the beginning. You should avoid bending or twisting motions right after surgery. Gradually do more each day, as your body allows and as your healthcare provider recommends.

Be sure to follow the instructions your provider gives you. Physical therapy (exercises and stretches that strengthen your muscles) may help you move more easily, with less pain.

Most people feel well enough to drive within a week to two weeks after surgery. You can go back to work (non-strenuous activities) within one month if you didn’t have spinal fusion with a laminectomy.

When should I call my healthcare provider?

Reach out to your healthcare provider about any symptoms that concern you after surgery. Pay particular attention to possible signs of infection or more serious complications your provider told you to look out for.

Always call your provider if you have:

• Skin discoloration, swelling or a foul odor near the incision site.
• Leg swelling or tenderness.
• Worsening pain near your incision site, shoulder or belly.
• Fever.
• Difficulty breathing or swallowing.
• Dizziness.
• Bowel or bladder management problems.
• Persistent drainage from the surgical site.

Is laminectomy surgery the same as a diskectomy?

Laminectomy (removal of lamina bone) and diskectomy (removing damaged disk tissue) are both types of spinal decompression surgery. Your surgeon may perform a diskectomy during a laminectomy procedure.