What is a Laminectomy?
A laminectomy, one of the most common back surgeries, is a surgical procedure to remove part or all of the lamina, the bone comprising the backside of each vertebra. The lamina act as a protective roof over the spinal cord.
Laminectomies are performed to enlarge the spinal canal and ease pressure on nerve roots caused by a herniated disc, injury, spinal stenosis (narrowing of the spinal canal) or tumors. A laminectomy is also done as part of back surgery when the surgeon may need to remove part of the lamina to gain access to a damaged disc or to remove bone spurs. A laminectomy can be done anywhere along the spine, from the neck (cervical) to the lower back (lumbar) and can be unilateral (on one side) or a bilateral (both sides).
What Does a Laminectomy Treat?
The lower back is one of the most vulnerable parts of the body, largely due to the stress it incurs over time. Whether from injury or wear and tear, this vulnerability can lead to a number of conditions which result in pressure on the spinal nerves, causing pain, numbness or weakness in the arms or legs. A laminectomy can help to relieve spinal pressure and thus the symptoms that result.
Two main conditions—disc herniation and spinal stenosis—are treated by a laminectomy. In addition, a laminectomy may also be performed to remove a spinal tumor.
- Herniated discs. A laminectomy helps ease the pressure which occurs from a leakage of material from a degenerated or damaged intervertebral disc.
- Spinal stenosis. Spinal stenosis describes a narrowing of the spinal canal which causes compression on the nerve roots and the spinal cord. A laminectomy is the most commonly used surgical procedure to treat this condition. Spinal stenosis can be caused by any of the following:
- A herniated disc, which is located between the vertebrae
- Bone spurs (bony overgrowths)
- Age-related osteoarthritis
- Enlarged facet joints, caused by degeneration. (The facet joints are located along the spine and provide back flexibility, motion and stability).
Who is a Candidate for Laminectomy?
To determine who is a good candidate for a laminectomy, doctors start with a comprehensive physical examination. In addition, a number of diagnostic tests are used to determine the source of symptoms and decide the best course of treatment.
A laminectomy is usually a next step for back or neck pain after other more conservative treatments, such as medication or physical therapy, have not worked or have been exhausted. Additionally, it may also be indicated if:
- Pain is significant.
- There is arm/leg weakness or numbness.
- There is muscle weakness to the degree that standing or walking is difficult.
- There is a loss of bladder or bowel control.
- Diagnostic tests such as magnetic resonance imaging (MRI), computed tomography (CT) or a myelogram show a more severe type of spinal stenosis.
How Is a Laminectomy Performed?
For laminectomy surgery, patients are positioned on the operating table on either their side or belly. Following the administration of anesthesia, the surgeon makes an incision on the back over the affected vertebra and then moves the muscles to access the lamina. The surgeon will then use small instruments to remove the lamina, in addition to any ruptured disc material or bony growths. Following the procedure, the incision will be closed using either stitches or surgical staples. A sterile dressing will then be applied. The surgery takes from one to three hours.
What is Recovery from Laminectomy Like?
Recovery from a laminectomy depends on the individual patient, as well as the extent of the surgery. In some cases, patients are able to go home the same day as surgery. However, one day hospital stays are common.
While there will be some back pain, medication is provided to ease it. Instructions for showering or bathing and how to keep the incision site clean and dry will be provided.
Most people can drive within one to two weeks. A return to light work usually takes about four weeks. Light activities such as walking and physical therapy will be recommended by the doctor and are encouraged to speed recovery. Activities such as bending or lifting will be limited for several weeks to months, depending on the extent of the surgery.
If you are experiencing back pain or pain radiating to the arms or legs, request an appointment at Edison Spine Center. Our expert surgeons can diagnose the cause of your pain and come up with a treatment plan that works for you and your life.