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 movements

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

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 older adults
• 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

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.

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:

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

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 fusion
• an infection in the surgical site or vertebral bones
• 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 embolism
• breathing difficulties
• an infection
• blood loss
• a heart attack
• a stroke
• a reaction to medication

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 walking
• 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

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.