Laminectomy

Laminectomy

(Lumbar Laminectomy, Cervical Laminectomy, Decompressive Laminectomy, Back Surgery, Disk Surgery)

Procedure overview

Illustration of a lumbar laminectomy
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What is a laminectomy?

Back pain that interferes with normal daily activities may require surgery for treatment. Laminectomy is a type of surgery in which a surgeon removes part or all of the vertebral bone (lamina) to relieve compression of the spinal cord or the nerve roots that may be caused by injury, herniated disk, spinal stenosis (narrowing of the canal), or tumors. A laminectomy is considered only after medical treatments have proven to be ineffective.

Other related procedures that may be used to help diagnose back problems include CT scan, X-ray, MRI, electromyogram (EMG), and myelogram. Please see these procedures for additional information

Anatomy of the spinal column

Anatomy of spinal column with vertebrae
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The spinal column, also called the vertebral column or backbone, is made up of 33 vertebrae that are separated by spongy disks and classified into four distinct areas. The cervical area consists of seven vertebrae in the neck; the thoracic spine consists of 12 vertebrae in the back area; the lumbar spine consists of five vertebrae in the lower back area; five sacral bones (fused into one bone, the sacrum); and four coccygeal bones (fused into one bone, the coccyx).

Reasons for the procedure

Low back pain can range from mild, dull, annoying pain, to persistent, severe, and disabling pain. Pain in the lower back can restrict mobility and interfere with normal functioning. Laminectomy may be performed to relieve pressure on the spinal nerves, treat a disk problem, or remove a tumor from the spine.

One common reason for undergoing 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 (generally, 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 are not satisfactory, back surgery may be an effective treatment. Some medical treatments for back pain may include, but are not limited to, the following:

Laminectomy is usually performed for back pain that continues after medical treatment, or when the back pain is accompanied by symptoms of nerve damage, such as numbness or weakness in the legs.

There may be other reasons for your doctor to recommend a laminectomy.

Risks of the Procedure

As with any surgical procedure, complications can occur. Some possible complications may include, but are not limited to, the following:

Nerve or blood vessels in the area of surgery may be injured, resulting in weakness or numbness. The pain may not be relieved by the surgery or may become worse, although this is rare.

There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your doctor before the surgery.

Before the procedure

During the procedure

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 performed while you are asleep under general anesthesia, or 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 on an outpatient basis. Your physician will discuss this with you in advance.

Generally, a laminectomy follows this process:

  1. You will be asked to remove clothing and will be given a gown to wear.
  2. An intravenous (IV) line may be started in your arm or hand.
  3. Once you are under anesthesia, a urinary drainage catheter may be inserted.
  4. If the surgical site is covered with excessive hair, the hair may be clipped off.
  5. You will be positioned either on your side or abdomen on the operating table.
  6. The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
  7. The skin over the surgical site will be cleansed with an antiseptic solution.
  8. The surgeon will make an incision over the selected vertebra.
  9. The surgeon will spread the back muscles apart.
  10. The lamina (bony arch of the posterior part of the vertebra) is removed to relieve the pressure on the nerves in the area. This may involve removing bone spurs or growths, or removing all or part of a disk.
  11. In some cases, spinal fusion may be performed at the same time. During a spinal fusion, the surgeon will connect two or more bones in the back to help stabilize the spine.
  12. The incision will be closed with stitches or surgical staples.
  13. A sterile bandage/dressing will be applied.

After the procedure

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 an in-hospital stay of one or more days.

You will most likely begin getting out of bed and walking the evening of your surgery. Your pain will be controlled with medication so that you can participate in the exercise. You may be given an exercise plan to follow both in the hospital and after discharge.

At home:

Once you are at home, it is important to keep the surgical incision area clean and dry. Your doctor 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 physician. Aspirin or certain other pain medications may increase the chance of bleeding. Be sure to take only recommended medications.

Notify your doctor to report any of the following:

You should not drive until your doctor tells you to. You should avoid bending over to pick up objects or arching your back. Other activity restrictions may apply.

Your doctor may give you additional or alternate instructions after the procedure, depending on your particular situation.

Online Resources

The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your doctor. Please consult your doctor with any questions or concerns you may have regarding your condition.

This page contains links to other websites with information about this procedure and related health conditions. We hope you find these sites helpful, but please remember we do not control or endorse the information presented on these websites, nor do these sites endorse the information contained here.

American Academy of Orthopaedic Surgeons

American College of Rheumatology

Arthritis Foundation

National Institute of Child Health and Human Development

National Institutes of Health (NIH)

National Library of Medicine

 

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