Laminectomy is a type of back surgery used to relieve compression on the spinal cord. It removes the lamina (part of the bone that forms the vertebral arch in the spine) and/or bone spurs. These structures can put pressure on the spinal cord or nerve roots and 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 is performed when less invasive treatments have failed.
The surgery is also called:
- lumbar laminectomy
- cervical laminectomy
- decompressive laminectomy
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:
- aging (the discs of the spine begin to shrink, while the bones and ligaments swell)
- arthritis of the spine (more common in the elderly)
- congenital defect (defects present at birth) such as abnormal spine growth
- Paget’s disease of bone (a condition in which bones grow improperly)
- achondroplasia (dwarfism)
- tumors in the spine
- traumatic injury
- herniated or slipped disc
A laminectomy is performed while you are under anesthesia. You may be asleep during the procedure (general anesthesia). You may be also be awake under spinal anesthesia. Either way, you will feel no pain during the procedure. An anesthesiologist will monitor you throughout the surgery.
During the surgery, your surgeon will generally:
- clean the skin over the surgical site with an antiseptic solution to help prevent a bacterial infection
- make a small incision (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 spine
- 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 spinal fusion, in which two or more bones are connected in the back to better stabilize the spine, or foraminotomy, in which the area where the nerve roots go through the spine is widened.
According to the National Institutes of Health, surgery takes one to three hours (NIH, 2010).
Risks of spine surgery include:
- damage to a spinal nerve
- unsuccessful treatment (pain persists after surgery)
- return of back pain (particularly after spinal fusion)
- infection in the surgical site or vertebral bones
General risks for surgery include:
- blood clots in the legs
- breathing difficulties
- blood loss
- heart attack
- reaction to medication
Tell your healthcare provider if you:
- take any drugs, vitamins, or supplements, whether prescription or over-the-counter
- are pregnant or think you could be pregnant
- are sensitive or allergic to any medications, anesthetic agents, tape, or latex
Before the surgery, your healthcare provider may ask you to:
- stop taking blood-thinning medications, such as aspirin
- stop smoking if you are 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.
When you wake up after surgery, your healthcare provider will usually ask you to get up and walk around a bit (unless you had a spinal fusion). You will probably stay in the hospital for one to three days.
While you are recovering, you should:
- avoid strenuous activity and heavy lifting
- climb stairs carefully
- walk and increase your activities gradually
- schedule and go to all follow-up appointments
While showering, do not scrub over the incision site. Do not apply any lotions or creams near the incision. Avoid bathtubs, hot tubs, and swimming pools until otherwise notified. These increase the risk of infection.
Your healthcare provider will give you specific instructions on how to take care of your wound.
Call your healthcare provider immediately if you experience:
- swelling on or near the incision site
- draining, heat, or redness on the incision site
- difficulty breathing or chest pain
- fever of 100 degrees Fahrenheit or higher
- tenderness or swelling in your legs
- difficulty urinating
- loss of bowel or urination control
Laminectomy will often relieve many symptoms of spinal stenosis. It cannot prevent spine problems in the future, however. It may also not completely relieve pain in all patients.
Patients who also have a spinal fusion are more likely to have spinal problems in the future.