Everything You Need to Know About a Laminectomy

What Is a Laminectomy?

The lamina is the back part of your vertebra covering the spinal canal. Your doctor could decide to eliminate your lamina or the bone spurs around it when either causes compression of your spinal cord or the roots of your nerves. Pressure on the roots of your nerves can cause:

• mild or severe pain in your back
• weakness or numbness in the legs
• difficulties when you walk
• difficulties in bladder control and bowel movements

Why Is a Laminectomy Performed?

All the effects of spinal stenosis, or narrowing of the spinal canal, can be relieved through a laminectomy. Stenosis of the spine results in the exertion of pressure on the nerves and spinal cord and comes as a result of any of the following:

• When with age, the discs of your spine shrink or your ligaments or bones swell
• When you happen to have arthritis of the spine
• When you have a congenital defect that leads to the defective growth of your spine
• When you happen to have Paget’s disease, which interferes with the proper growth of the bones
• When you have a condition known as achondroplasia, a type of dwarfism
• When there is a tumor affecting your spine
• When you have had a traumatic injury
• When your disc has slipped to one side

How Do I Prepare for a Laminectomy?

Inform your doctor if you:

• are taking any over-the-counter drugs, food supplements, or vitamins
• are or suspect you might be pregnant
• have allergies related to anesthetics, latex, or any medicine

Prior to your surgery, your doctor may request you to:

• stop smoking cigarettes in case you do.
• stop using certain kinds of medication or blood thinners
• eat nothing at least six hours prior to the surgery.

It is important to arrange for someone to pick you up once you are discharged from the hospital and assist you at home in the days after the surgery.

How Is a Laminectomy Performed?

You will be under general anesthesia and unconscious during your laminectomy. These are the other things you should expect:

• You will be given sedatives to make your muscles to relax. You will also be made to inhale anesthetic gas and oxygen through a mask. 
• The anesthesiologist will perform a procedure known as intubation, the insertion of a plastic tube through your trachea.
• A breathing machine will be attached to you to help you breathe during the surgery. It will push air into and out of your lungs.
• Your movements and vital signs will be monitored throughout the procedure.
• You will be lying on your stomach. This posture is to make your back is accessible to your surgeon.

The Laminectomy:

• Your surgeon will cut through your skin around the area affected. The surgeon will leave your spine exposed by pulling to the side your tissues and muscles.
• The surgeon will refer to the reason for surgery in cutting either your ligaments, the spurs of your bones, or the bones causing the compression of the nerves.
• This procedure is known as decompression and may involve the removal of large or small parts of the spinal cord.
• The surgeon may decide to perform a spinal fusion, either a bone graft or metal implant, on you. This is meant to make your spine more stable. The surgeon may also opt to remove a disc or more bone to create room in the area through which nerves leave the spinal canal.

Once the surgery is completed, your gas anesthesia will be shut off and you will be stitched up. You will be relieved of the breathing tube and turned over on your back.

What are the Risks and Possible Complications?

A laminectomy, just like other surgeries, carries risks related to the surgery. The complications you may experience are as follows:

• You may bleed severely.
• You may acquire an infection.
• You may sustain nerve injury.
• The fluids in your spine may leak.
• You may have persistent pain after the surgery.
• Your spine may not be stable after a spinal fusion surgery.

The risks should not worry you, however, as the benefits of this surgery are way more than the risks. Also, in case the reason for the surgery is osteoarthritis, you may still develop arthritis later on. 

What Happens After a Laminectomy?

After the operation and for up to two days afterward, you will be given ice chips and clear liquids. When normal bowel function returns, usually after the second day, you will be able to go back to a regular diet. Your doctor will put you through physical therapy after the third day to exercise and strengthen your back. You may need to be assisted when getting up and walking, and will likely be given strong painkillers.

You will also be given a back brace to support your back when you walk or sit. Ensure you have it on even though you may feel like sitting in some postures without it. Once you are back at home, you may go for a short while without the brace when using the bathroom.

At Home

• Wait for your doctor’s instructions before going back to work.
• For at least six weeks, and while you're still wearing the back brace, do not drive. 
• Avoid long trips until your doctor allows you to or you might get blood clots in your legs.
• It is important that you walk as a form of exercise.  
• Until your doctor allows it, avoid strenuous work.
• Avoid bending as this strains your back.
• Avoid lifting or pulling anything heavier than three kilograms.
• Try as much as you can to keep your incisions dry.
• Avoid as much as you can moving your neck from side to side.
• Do not sleep on your stomach--you may choose any other comfortable position.
• You may resume having sex when your doctor tells you it is ok.
• Avoid overstuffed chairs.
• Ask someone to help you check the physical appearance of your incisions daily.
• Your hospital will arrange for devices to help you during the recovery period. Use them according to instructions.

A laminectomy will help you get rid of future spinal conditions, though it may not completely relieve you of pain. If you have a spinal fusion, you may experience other problems in the future.