What is a laminectomy?
Back or neck pain that interferes with normal daily activities may need surgery for treatment. Laminectomy is a type of surgery in which a surgeon removes part or all of the vertebral bone (lamina). This helps ease pressure on the spinal cord or the nerve roots that may be caused by injury, herniated disk, narrowing of the canal (spinal stenosis), or tumors. A laminectomy is considered only after other medical treatments have not worked.
Why might I need a laminectomy?
Low back or neck pain can range from mild, dull, and annoying to persistent, severe, and disabling. Pain in the spine can restrict your ability to move and function. Laminectomy may be done to ease pressure on the spinal nerves, treat a disk problem, or remove a tumor from the spine.
One common reason for having a laminectomy is a herniated disk in the spine.
A disk may be displaced or damaged because of injury or wear and tear. When the disk presses on the spinal nerves, this causes pain, and sometimes numbness or weakness. The numbness or weakness will be felt in the body part where the nerve is involved, often the arms or legs. The most common symptom of a herniated disk is sciatica. This is a sharp, shooting pain along the sciatic nerve, extending from the buttocks to the thigh and down the back of the leg.
If medical treatments no longer work, surgery may be a choice. Some medical treatments for pain may include:
- Changes in activity
- Medicines, such as muscle relaxants, anti-inflammatory medicines, and pain relievers
- Spinal injections
- Physical rehabilitation, physical therapy, or both
- Occupational therapy
- Weight loss (if overweight)
- Smoking cessation
- Assistive devices, such as mechanical back supports
Laminectomy is usually done for back or neck pain that continues after medical treatment. Or it is done when the pain is accompanied by symptoms of nerve damage, such as numbness or weakness in the arms or legs. Loss of bowel or bladder control from pressure in the cervical or lumbar spine also usually needs surgery.
There may be other reasons for your healthcare provider to recommend a laminectomy.
What are the risks of a laminectomy?
As with any surgical procedure, complications can occur. Some possible complications may include:
- Blood clots in the legs or lungs
- Spinal cord or nerve root injury
- Risks linked to the use of general
Nerve or blood vessels in the area
of surgery may be injured. This can cause weakness or numbness. The pain may not be
eased by the surgery or may become worse, although this is rare.
There may be other risks depending
on your specific health condition. Be sure to discuss any concerns with your healthcare
provider before the surgery.
How do I get ready for a laminectomy?
What happens during a laminectomy?
A laminectomy usually requires a stay in a hospital. Procedures may vary depending on your condition and your doctor’s practices.
A laminectomy may be done while you are asleep under general anesthesia. Or it may be done while you are awake under spinal anesthesia. If spinal anesthesia is used, you will have no feeling from your waist down. Newer techniques are being developed that may allow a laminectomy to be done under local anesthesia as an outpatient. Your doctor will discuss this with you in advance.
Generally, a laminectomy follows this process:
- You will be asked to remove clothing and will be given a gown to wear.
- An IV (intravenous) line may be started in your arm or hand.
- Once you are under anesthesia, a urinary drainage catheter may be inserted.
- If the surgical site is covered with extra hair, the hair may be clipped off.
- You will be positioned either on your side or belly on the operating table.
- The anesthesiologist will continuously watch your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
- The healthcare staff will clean the skin over the surgical site with an antiseptic solution.
- The surgeon will make a cut (incision) over the selected vertebra.
- The surgeon will spread the muscles apart.
- The surgeon removes the bony arch of the posterior part of the vertebra (lamina) to ease the pressure on the nerves in the area. This may involve removing bone spurs or growths, or removing all or part of a disk.
- In some cases, spinal fusion may be done at the same time. During a spinal fusion, the surgeon will connect 2 or more bones in your spine.
- The incision will be closed with stitches or surgical staples.
- A sterile bandage or dressing will be applied.
What happens after a laminectomy?
In the hospital
After the surgery, you will be
taken to the recovery room for observation. Once your blood pressure, pulse, and
breathing are stable and you are alert, you will be taken to your hospital room.
Laminectomy usually requires that you stay in the hospital one or more days.
You will most likely start
getting out of bed and walking the evening of your surgery. Your pain will be
controlled with medicines so that you can take part in the exercise. You may be given
an exercise plan to follow both in the hospital and after discharge.
Once you are at home, it's
important to keep the surgical incision area clean and dry. Your healthcare provider
will give you specific bathing instructions. The surgical staples or stitches are
removed during a follow-up office visit.
Take a pain reliever for
soreness as recommended by your healthcare provider. Aspirin or certain other pain
medicines may increase the chance of bleeding. Be sure to take only recommended
Tell your healthcare provider
about any of the following:
- Redness, swelling, bleeding, or
other drainage from the incision site
- Increased pain around the incision
- Numbness in your legs, back, or
- Trouble urinating or loss of
control of your bladder or bowel
Don't drive until your
healthcare provider tells you it's OK. Don't bend over to pick up objects or arch
your back. Your provider may tell you to limit other activities.
Your healthcare provider may
give you other instructions after the procedure, depending on your particular
Before you agree to the test or the procedure make sure you know:
- The name of the test or procedure
- The reason you are having the test or procedure
What results to expect and what they mean
- The risks and benefits of the test or procedure
What the possible side effects or complications are
- When and where you are to have the test or procedure
Who will do the test or procedure and what that person’s qualifications are
What would happen if you did not have the test or procedure
Any alternative tests or procedures to think about
- When and how will you get the results
Who to call after the test or procedure if you have questions or problems
- How much will you have to pay for the test or procedure