What Is a Laminectomy?
A laminectomy is a kind of surgery whose aim is to decompress the spinal cord. The lamina (the bone that constitutes spinal‘s vertebral arch) and bone spurs are removed during the operation. Both the lamina and bone spurs can compress your spinal cord leading to:
- Mild or severe or back pain
- Leg numbness or weakness
- Problems in walking
- Inability to control bowel movements and the bladder
A laminectomy is resorted to only when the above symptoms make it difficult for you to perform your daily activities and the less invasive treatment options aren’t successful.
A laminectomy is also referred to as decompressive laminectomy. The procedure has specific names depending on the location of the lamina removed:
- Lumbar laminectomy - the removal of the lamina in the lower back
- Cervical laminectomy - the removal of the lamina in the neck area
- Sacral laminectomy - the removal of the lamina between your hip or pelvic bones
- Thoracic laminectomy - removal of the lamina in the middle section of your back
Reasons for Having a Laminectomy
A laminectomy is performed to make the impact of spinal stenosis (the narrowing of the spaces in your spine) less severe. Spinal stenosis narrows the spinal column, causing compression of the nerves or spinal cord. Spinal stenosis occurs as a result of the following:
- Spinal arthritis
- A birth defect
- Paget's disease of bone
- A spinal tumor
- A traumatic injury
- A herniated or slipped disc
A laminectomy is carried out with the patient sometimes under local but usually general anesthesia. The anesthesia prevents you from feeling pain during the surgical operation. Your anesthesiologist monitors you during the entire procedure.
While performing the operation, a surgeon:
- Cleans the skin of the area to be operated on using an antiseptic solution to prevent infection
- Makes a tiny cut in the middle of the patient’s neck or back
- Strives to get a better view of the spine by moving the patient’s ligaments, skin, and muscles
- Removes a section of or the entire spinal lamina
- Removes small fragments of the disc or bone spurs
- Closes the cut by stitching
- Uses sterile bandages to cover the incision
During a laminectomy, the surgeon may also perform a spinal fusion to improve the stabilization of your spine. The surgeon may also carry out a foraminotomy to widen the region where the nerve roots enter the spine.
A laminectomy normally requires one to three hours to complete.
Preparing for a Laminectomy
Disclose the following details about yourself to your doctor:
- Any prescribed or over-the-counter drugs, supplements, and vitamins that you take
- Suspected or confirmed pregnancy
- Any allergic reaction to drugs, latex, surgical tape, or anesthetic agents
Your physician may require you to do the following before the operation:
- Abstain from smoking
- Avoid taking blood-thinning medication like aspirin
- Avoid eating or drinking anything past midnight the night before the operation.
It is important to arrange for someone to drive you home after you're discharged from the hospital and assist you for some days as you recover.
Risks Associated with Laminectomy
These problems may occur during or following the spinal surgery:
- Spinal nerves may be damaged.
- It may be ineffective, with pain not going away even after the operation.
- Back pain may recur, especially following spinal infusion.
- The vertebral bones or the surgery site may become infected.
- Cerebrospinal fluid may leak when the dura mater is torn.
The risks related to surgery in general are:
- Loss of blood
- Heart attack
- An adverse reaction to medication
- A blood clot in the leg possibly leading to a pulmonary embolism
- Breathing problems
What to Expect After a Laminectomy
Your physician will ask you to stand and walk around after you wake up following the operation, unless you had a spinal infusion. You may have to stay in the hospital for a day to three days, although there's a chance you might be allowed to go home on the same day as the surgery, depending on the type of surgery you had and your condition.
As you recover, you must:
- Abstain from performing strenuous activities and lifting heavy weights
- Be cautious when climbing stairs
- Increase, but gradually, activities like walking
- Have follow-up appointments with your doctor
When taking a shower, protect the wound with cling wrap and surgical tape and do not scrub over it. Do not apply creams or lotions on it, unless instructed by your doctor. Don’t swim or immerse yourself in a bathtub without your doctor’s go-ahead.
Contact your doctor right away if you experience any of the following symptoms:
- Difficulty breathing
- Chest pain
- Fever of 100ºF or higher
- Swollen or tender legs
- Difficulty urinating
- Urinary or bowel incontinence
- Swelling at the incision site or surrounding areas
- Red, hot, or draining/leaking incision
Back Pain Facts
- Back pain causes the most loss of work productivity compared with other medical conditions.
- Women are more vulnerable to back pain than men are.
- Whites are more susceptible to back pain compared with other ethnicities.
- Back pain usually affects people aged 45 to 64 years.
- Acute back pain mostly arises from muscles, while chronic back pain is usually caused by lumbar degeneration.
Special Types of Back Pain That Could Require Surgery
- Sciatica pain, which is characterized by a herniated disc and pain in the nerves extending to a lower extremity (through the back of and into one leg or both).
- Cauda equina syndrome, which is the excessive compression of all the lumbar spinal nerves' locations. This rare problem can lead to uncontrollable bowel and bladder movements, requiring immediate surgical intervention to decompress the entrapped nerves.
Types of Back Surgeries for Root Compression Relief
Your doctor may perform a combination of the following surgical operations to decompress your nerve roots:
1. Laminotomy - A part of the lamina of the spine is removed.
2. Laminectomy - Most of the spine's lamina is removed, and is done when a less invasive medical treatment fails to treat back pain successfully.
3. Discectomy - The spinal disc is wholly or partially removed.
Home Recovery Following a Laminectomy
You can ease your home recovery through the following:
- Before the surgery, place supplies such as toiletries and groceries at hip and shoulder level so that they’re within reach without you having to bend over or stretch.
- Make sure that you have someone to assist you--to drive you around, do your household chores, and run errands.
- Wear a pair of slip-on shoes so they can be put on without you having to bend over.
- Going on brief walks every day may minimize your pain and also make you heal faster.
- Normally, if your occupation requires you to be seated most of the time, you can resume work within one or two weeks. People whose jobs are strenuous may be required to desist from working for two to four months.
- You may feel ready for sex once your back recovers from the surgery; it is normally okay, although ask for your doctor's clearance and ensure that you choose a position that doesn’t put much pressure on your back.
- Some medications may make you feel dizzy. Avoid driving for 7 to 14 days if this is the case.
- Follow your doctor’s guidance with regard to physical therapy.
A laminectomy usually relieves many of the symptoms of spinal stenosis. Nevertheless, the surgical operation can’t prevent spine-related issues from occurring in the future. Also, the operation doesn’t always fully relieve pain for everyone who's had it. It is advisable for a patient to learn ways to prevent the recurrence of any spinal condition. Contact your doctor if you notice any symptoms that suggest the recurrence of back problems.
Note, too, that the chances of developing spinal issues in the future are high for people whose spines have been fused.