A lumbar laminectomy is a surgery that treats compression of the spinal cord in your lower back. The surgery involves removing all or part of your vertebra called the lamina.

The lamina is the part of your vertebra that connects the body to the spiny part you can feel along your neck and back.

An estimated 200,000 or more U.S. adults have spinal nerve compression in their lower back, which is also called lumbar spinal stenosis. Doctors usually try to treat it with nonsurgical methods first, but they may recommend laminectomy or another surgery if those methods aren’t effective.

Keep reading to learn more about lumbar laminectomies, including what happens during the procedure, how long it takes to recover, and if there are any potential side effects.

A laminectomy is one of the most common procedures for decompressing the spinal cord and nerve roots. It’s usually the procedure of choice for middle aged and older adults with compression caused by degeneration.

Central spinal stenosis: The basics

Your spinal cord is the main nerve that runs from your brain down your spine. It runs through a hole in the middle of each vertebra called the spinal canal.

Gradual wear and tear of your vertebrae and conditions like herniated discs can compress your spinal cord. Compression in your lower back can cause the following symptoms:

  • pain and stiffness in your lower back
  • burning pain down your legs
  • numbness and weakness in your legs
  • loss of sensation in feet
  • loss of bladder or bowel control
  • loss of sexual function
Was this helpful?

Typically during a laminectomy, the surgeon will remove the entire rear of a vertebra. This procedure can be performed on one or more vertebrae. If only one lamina is removed, the procedure is called a hemilaminectomy. If only part of the lamina is removed, it’s called a laminotomy.

When one of the laminae is cut, but the rear of the vertebra isn’t removed, the procedure is called a laminoplasty.

Surgeons use several different surgical techniques to perform a laminectomy. They can do it as an open surgery, which is most common, or as a minimally invasive procedure called microlaminectomy, which is performed under microscopic magnification with a smaller incision.

In a 2017 study, researchers found that microlaminectomy was associated with shorter hospital stays and reduced costs in a small group of people. The researchers speculated that the shorter hospital stays were due to a reduction in post-surgery pain and avoiding the need for a wound drain.

Here’s a general idea of what you can expect during the classic open laminectomy:

  1. You’ll be positioned face down and be given general anesthesia through an IV inserted into a vein in your hand or arm. A plastic tube will be inserted into your throat to help you breathe during the procedure.
  2. Your surgeon will make an incision in the middle of your lower back. They’ll use special devices to hold back the muscle, skin, and fat so that they can access the bone.
  3. Once they identify the correct location, they’ll cut the laminae and remove the rear part of the vertebra.
  4. The surgeon will repeat the procedure on as many vertebrae as necessary.
  5. Once they’re finished, they’ll close the wounds with stitches. You may have a wound drain placed after the surgery, which is usually taken out within a few days.

According to the American Association of Neurological Surgeons, you may be a candidate for surgery if you have:

  • back and leg pain limiting normal activity or quality of life
  • progressive neurological conditions like leg weakness
  • loss of bowel function or bladder function
  • trouble walking or standing
  • no relief from medications and physical therapy
  • good overall health

Doctors usually try to treat spinal compression with more conservative methods before recommending surgery. A laminectomy is a common but fairly extensive surgery.

To be eligible, you need to be in good overall health and be able to undergo general anesthesia. People with multiple health conditions or other spinal conditions like scoliosis may not be eligible.

Microlaminectomy is considered a minimally invasive procedure because it requires a smaller incision.

Many people experience pain relief after receiving a laminectomy or other decompressive surgery.

In a 2021 study, researchers found that 73% of 2,699 people who underwent lumbar decompression surgery experienced clinically significant symptom improvements within 2 years.

That same study found that within 3 months, 61% achieved clinically significant improvement after primary surgery and 41% after redo surgery.

Recommendations for activities after surgery

You’ll likely be able to return to light activities within days or weeks of your operation, but it’ll take longer to resume heavier, more physical activity.

In a 2020 study that surveyed 56 spinal surgeons, researchers reported the following recommendations:

  • Driving can be safely resumed an average of 1 week after one-level laminectomy.
  • Most surgeons recommend waiting 2 weeks to drive after multi-level lumbar laminectomy.
  • Light work, such as clerical work, can usually be resumed after 2 weeks.
  • There was variability in recommendations about resuming medium work, which included nursing and truck driving, but surgeons recommended an average of 6 weeks.
  • Surgeons recommended 8 weeks before starting heavy work after a single-level laminectomy and 8 to 12 weeks for multi-level. Heavy work included activities such as construction work or bricklaying.
  • Low impact exercises such as stationary bike riding can be resumed after an average of 4 weeks.
  • Non-contact sports can be resumed after about 8 weeks.
  • Contact and high risk sports shouldn’t be resumed for at least 3 months.
Was this helpful?

A laminectomy is generally considered a safe procedure, but like all surgeries, it comes with some risks.

In a large 2020 study, researchers found that the risk of developing a complication within 30 days of single-level laminectomy was 6.7% for inpatient procedures and 1.9% for outpatient. The risk was 7.38% for two-level inpatient procedures and 3.17% for outpatient. People in the outpatient group tended to be younger and have less obesity and fewer health complications.

Inpatient means spending one or more nights in the hospital and outpatient means going home the same day.

In a 2015 study, researchers reported the following complications in a group of 500 people:

  • tear of the dura, the outer cover of the spinal cord: 10%
  • spinal fluid leaked: 1.6%
  • deep vein thrombosis: 0.2%
  • pulmonary embolus (blood clot in the lung): 0.2%
  • infection: 2.4%
  • stitches separation: 0.4%
  • reoperation: 14.4%

In very rare cases, spinal decompression surgery can lead to damage to the spinal cord, which may cause weakness and numbness in your legs. Paralysis is an uncommon but serious complication.

Lumbar laminectomy is a surgery to treat spinal compression in your lower back. It involves removing the rear of one or more vertebrae. It’s usually a safe and effective treatment for spinal compression, but you need to be in good overall health to undergo general anesthesia.

Your doctor may recommend a lumbar laminectomy if other nonsurgical treatments don’t help manage your pain. They can also help you determine which type of spinal decompressive surgery is best for you.