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Laminectomy

Click here to view an animated version of this procedure.

Definition

A laminectomy is a surgery to remove a small portion of a vertebra. Vertebrae are the bones of the spine. The part removed is called the lamina.

In some cases, only a portion of the lamina is removed from the vertebra. The part removed is above and below a pinched nerve. This procedure is known as laminotomy.

Laparoscopic Laminectomy
Laparoscopic Laminectomy
Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure

A laminectomy is usually done to help take pressure off your spinal cord or a nerve running out from your spinal cord. It is also done to gain access to the spinal cord, bones, and discs that are below the lamina. Herniated discs , bony spurs, or other problems can cause narrowing of the canals that the nerves and spinal cord run through. This can irritate the nerve if it gets too narrow. Often, a laminectomy is done along with a disk removal to help make the canal larger and take pressure off the nerve being irritated.

When the spinal cord or other nerves get irritated, they can cause:

  • Weakness
  • Numbness
  • Pain in an arm or leg

Physical therapy and medication will be tried first.

The surgery is done when other treatments have not worked. It is most often done to treat symptoms that keep getting worse.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Infection
  • Bleeding
  • Blood clots
  • Damage to nerves, resulting in pain, numbness, tingling, or paralysis
  • Problems related to anesthesia

Factors that may increase the risk of complications include:

  • Another medical condition, particularly heart or lung problems
  • Obesity
  • Increased age
  • Smoking

What to Expect

Prior to Procedure

Your doctor may do the following:

In the time leading up to your surgery:

  • If you are overweight, talk to your doctor about how to successfully lose weight. This will decrease the amount of stress on your back.
  • Talk to you doctor about your medications. You may need to stop certain medications up to a week before your procedure.
  • Arrange for a ride home and for help at home.
  • Eat a light meal the night before. Avoid eating or drinking anything after midnight.

Anesthesia

Possible types of anesthesia for this operation include:

Description of the Procedure

If the surgery is done with minimally invasive techniques, you will only need a few small incisions. A scope and small instruments will be inserted into these incisions. The lamina will then be removed using a drill or other tools. After the lamina is removed, the spinal cord and discs that were hidden under the lamina will be inspected.

In some cases, open surgery will be done. This involves making a larger cut in the skin over the area in the back.

The disc often needs to be removed as well to take pressure off the spinal cord. If it is not a disc problem, other problems causing the nerve irritation will be fixed. In rare cases, a spinal fusion may be done. A spinal fusion will involve joining two vertebrae. Lastly, the incision will be closed with stitches or staples.

Laparoscopic Removal of Disc Tissue
laparoscopic discectomy small
Copyright © Nucleus Medical Media, Inc.

How Long Will It Take?

1-3 hours

How Much Will It Hurt?

You will have pain during recovery. Your doctor will give you pain medication.

Average Hospital Stay

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Post-procedure Care

At the Hospital

While you are recovering at the hospital, you may receive the following care:

  • You will have to walk with assistance the evening after surgery or the next day.
  • You may need to wear a back or neck brace.
  • You may need to wear special socks or boots. These will help to prevent blood clots.
At Home

Your activities will be restricted while you heal. The incision area will need to be cared for to prevent wound infection. Some activity is necessary to improve circulation, promote healing, and reduce the risk of blood clots. When you are ready, you will be referred for physical therapy. Exercises will help strengthen muscles and improve flexibility. Your doctor may advise medications to help with swelling and pain.

Call Your Doctor

It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
  • Peristent nausea and/or vomiting
  • Pain that you cannot control with the medications you've been given
  • Cough, shortness of breath, or chest pain
  • Trouble urinating or having a bowel movement
  • New numbness or weakness in the hips, groin, or legs
  • Joint pain, fatigue, stiffness, rash, or other new symptoms

If you think you have an emergency, call for medical help right away.

Revision Information

  • Family Doctor—American Academy of Family Physicians

    http://familydoctor.org

  • National Institute of Neurological Disorders and Stroke

    http://www.ninds.nih.gov

  • Health Canada

    http://www.hc-sc.gc.ca

  • The College of Family Physicians of Canada

    http://www.cfpc.ca

  • Allen RT, Garfin SR. The economics of minimally invasive spine surgery: The value perspective. Spine. 2010;35(26 Suppl):S375-S382.

  • Djurasovic M, Glassman SD, et al. Contemporary management of symptomatic lumbar spinal stenosis. Orthop Clin North Am. 2010;41(2):183-191.

  • Herniated disc. American Association of Neurological Surgeons website. Available at: http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Herniated%20Disc.aspx. Updated December 2011. Accessed November 25, 2013.

  • Lindström D, Azodi O, et al. Effects of a perioperative smoking cessation intervention on postoperative complications: A randomized trial. Ann Surg. 2008;248(5):739-745.

  • Pain: Hope through research. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/chronic%5Fpain/detail%5Fchronic%5Fpain.htm. Updated August 30, 2013. Accessed November 25, 2013.