Laminectomy Procedure
Overview
Laminectomy is a type of spinal surgery that removes part of the vertebra, known as the lamina. The lamina forms the back part of the spinal canal, and removing it creates more space around the spinal cord and nerves. This procedure is also known as decompression surgery.
Doctors most often use laminectomy when bone spurs or other growths narrow the spinal canal. These changes, which commonly develop with age or because of arthritis, can put pressure on the nerves or spinal cord. Some people may also be more likely to develop these issues due to family history.
Key points about laminectomy:
- Doctors usually recommend it when other treatments have not worked.
- Surgeons can perform it on various parts of the spine, including the lumbar region.
- The goal is to lessen symptoms like pain, weakness, or numbness.
- Recovery may vary based on the location and type of surgery.
Reasons for the Procedure
Doctors often use laminectomy to reduce pressure on the nerves in the lumbar spine. This pressure can result from the narrowing of the spinal canal, also known as spinal stenosis.
Common reasons for this narrowing include bony growths, also called osteophytes or bone spurs, and changes in the facet joints or vertebral discs. When these structures increase in size, they can push on nerves or the spinal cord. Symptoms that can lead to this procedure include:
- Persistent leg pain or sciatica
- Numbness or weakness in the lower back or legs
- Difficulty standing or walking
- Loss of bowel or bladder control
Doctors may suggest a laminectomy if other treatments like medicine or physical therapy have not helped. Sometimes, surgeons also perform it to reach and treat a damaged intervertebral disc. The aim is to create more space in the spinal canal and help patients move and function better.
Possible Problems
Common risks linked with laminectomy and spinal fusion include:
- Bleeding
- Infection
- Blood clots
- Nerve damage
- Spinal fluid leak
- Bladder issues
Patients should be aware that complications may happen, even if the chance is low.
Steps for Getting Ready
An orthopedic surgeon will review medical history and decide on the use of general anesthesia. Doctors might schedule diagnostic tests like x-rays. Patients may need to pause certain medicines, especially blood thinners. Before the procedure, patients should stop eating and drinking for several hours as advised by their healthcare team.
What You Can Expect
Steps Taken During the Procedure
Doctors usually perform a laminectomy while the patient is under general anesthesia. The anesthesiologist ensures the patient is not conscious and cannot feel pain. Throughout the operation, the medical team closely monitors important signs such as heart rate, blood pressure, and oxygen levels.
The surgeon begins the process with an incision in the skin over the affected vertebral bones. The surgical team gently moves the muscles away from the spinal column so the surgeon can reach the spinal canal. Using special tools, the surgeon removes a small part of the lamina, the bony covering that forms the back of the vertebrae and protects the spinal nerve and spinal cord.
If a herniated disc causes the problem, the surgeon also removes the injured disc material next to the nerve roots—a step called a discectomy. In some cases, such as when one vertebral body slips over another or when correcting spine shape, the surgical team performs a spinal fusion.
With spinal fusion, the surgeon permanently joins two or more vertebrae using bone grafts or a bone graft substitute. Sometimes, surgeons use rods and screws for added support. Surgeons using minimally invasive methods make a smaller incision and use special microscopes, which may lead to less muscle damage and shorter healing time.
Common Steps
| Step | Description |
|---|---|
| Anesthesia | Patient receives general anesthesia. |
| Incision | A surgeon makes a cut over the affected vertebrae. |
| Lamina removal | Surgeon removes the smallest possible part of the lamina. |
| Discectomy (if needed) | The surgeon removes herniated disc material. |
| Spinal fusion (if needed) | Vertebral bodies are joined, bone grafts or substitutes used |
| Closure | The surgeon stitches or staples tissue and skin shut. |
What Happens After Surgery
After the operation, staff take patients to a special area called the recovery room. Nurses and doctors carefully check for any early problems from surgery or anesthesia. Medical staff often ask patients to move their arms and legs to check nerve function.
Pain at the incision site is common, and doctors use medicine to help manage it. Most people spend one or two nights in the hospital, though patients with more complex surgeries like spinal fusion may stay longer. Many people work with a physical therapist after their laminectomy to regain strength, flexibility, and mobility in the back and legs.
Returning to daily life depends on the specific procedure and the patient’s job activities. For some, going back to work may be possible within a few weeks. Recovery takes longer when a spinal fusion has been performed, sometimes up to six months for full healing.
Key Points
- Watch for pain, swelling, or signs of infection at the incision.
- Start slow movements and exercises as advised.
- Expect a gradual return to normal activities.
- Additional care and time may be required if a bone graft or fusion was done.
Outcomes
Many individuals notice a reduction in leg or arm pain after laminectomy, along with some relief from numbness and tingling sensations. Muscle weakness often improves during recovery. Healing and rehabilitation can include physical therapy to boost strength and mobility. Quality of life may improve, though some lingering discomfort can remain with certain conditions.
