Laminectomy is a surgery that creates space within the spinal canal by removing the lamina—the back part of your vertebra that covers your spinal canal. Laminectomy surgery is sometimes referred to “decompression surgery” as it also relieves pressure on the spinal cord and/or nerve roots. Usually the pressure is caused by bony overgrowths referred to as “bone spurs” secondary to arthritis within the spinal canal. Bone spurs will develop overtime with aging.
Once conservative treatment including but not limited to anti-inflammatory medications, neuropathic medications, physical therapy and/or corticosteroid injections have failed, a laminectomy may be recommended if severe symptoms persist or progress rapidly. Indications for the procedure include excessive back pain, numbness that may radiate down your arms or legs, muscle weakness making it difficult to stand or ambulate for a prolonged period of time or if you lose control of your bowel or bladder. In rare cases, a laminectomy may be more urgent to treat a herniated disc within the spinal canal.
For the most part, a laminectomy is a safe procedure that will require general anesthesia. The surgeon will typically make a small incision (depending on your body size) in your back and move certain muscles away to gain access to your spine. Depending on the condition, the surgeon may use a smaller incision (minimally-invasive) and a surgical microscope to perform the operation.
After the laminectomy, you are moved to a recovery room so that medical professionals can monitor you for complications after surgery and anesthesia. Potential complications include bleeding at the site of surgery (hematoma), infection, blood clots, additional nerve injury or cerebrospinal fluid leak. They will do a full neuromuscular physical exam and you may be able to go home the same day or have a short stay within the hospital. If the surgery includes a spinal fusion, your hospital length of stay is usually longer and you may be discharged to an acute rehabilitation unit prior to going home.
Post-operative care includes sitting upright to support your back for no more than 30 minutes at a time. You should lie on a firm mattress, and avoid soft couches or recliners. You may lie on your side, but not on your stomach. You should avoid bending, lifting anything greater than 10 pounds, pushing, twisting, stooping or straining for approximately 6 to 8 weeks until you are cleared for normal activity by your surgeon. These are typically referred to as spine precautions. You will also have to keep your surgical incision clean and dry, being careful when you bathe or shower as to not get the area wet, which can exacerbate infection risk. Lastly, you may require stronger prescription pain medication up to two weeks after the surgery, which is quite normal. The staples or sutures that were placed to keep the incision closed are typically removed after 2 weeks. After a simple laminectomy, most people should expect a full recovery within 2-4 months.
Brox JI, Reikerås O, Nygaard Ø, et al. Lumbar instrumented fusion compared with cognitive intervention and exercises in patients with chronic back pain after previous surgery for disc herniation: a prospective randomized controlled study. Pain 2006; 122:145.
Herkowitz HN, Kurz LT. Degenerative lumbar spondylolisthesis with spinal stenosis. A prospective study comparing decompression with decompression and intertransverse process arthrodesis. J Bone Joint Surg Am 1991; 73:802.
Weinstein JN, Lurie JD, Tosteson TD, et al. Surgical compared with nonoperative treatment for lumbar degenerative spondylolisthesis. four-year results in the Spine Patient Outcomes Research Trial (SPORT) randomized and observational cohorts. J Bone Joint Surg Am 2009; 91:1295.