Laminectomy is a type of surgery that relieves compression on the spinal cord. A doctor may recommend this surgery for people who experience chronic back pain that does not improve with other forms of treatment.
Laminectomy involves the partial or complete removal of the lamina, which is part of the vertebral bone. Doctors typically use this procedure for treating the symptoms of spinal stenosis and conditions such as herniated disks.
This article covers different types of laminectomy and what to expect during and after the procedure.
The lamina is a part of the vertebrae that covers and protects the spinal canal. Laminectomy is a type of back surgery in which a surgeon removes part or all of the lamina.
Some people may refer to the surgery as a posterior spinal decompression.
Doctors use laminectomy to widen the spinal canal and relieve pressure on the spinal cord, or to remove bone spurs that compress nerve roots.
Some different types of laminectomy include:
- Cervical laminectomy: This is a procedure that a surgeon performs on a cervical vertebra in the neck.
- Lumbar laminectomy: This involves the vertebrae in the lower back. This procedure can help relieve pain in the lower back, buttocks, and legs.
- Sacral laminectomy: This procedure removes the lamina on the fused sacral vertebrae.
Some other forms of decompressive spinal surgery include laminotomy and discectomy.
Laminotomy is similar to laminectomy. However, during laminotomy, a surgeon removes just a small part of the lamina. According to the authors of one 2017 review article, this is a less invasive procedure. It may also lead to fewer complications, compared with traditional laminectomy.
Discectomy involves the partial or complete removal of a damaged intervertebral disk. Intervertebral disks consist of thick rings of cartilage. These cartilage disks cushion the vertebrae and act as shock absorbers for the spine.
Spinal stenosis occurs when the spinal canal narrows, putting pressure on the spinal cord or nerve roots.
Depending on the location and severity, spinal stenosis can lead to:
- pain in the neck or lower back
- numbness, aching, or tingling that radiates from the arms into the hands
- numbness or aching that runs down the buttocks and into the legs
- cramping or weakness in the hands, arms, legs, or feet
- difficulty walking
- difficulty controlling bladder or bowel movements
A person may develop spinal stenosis for several different reasons, but aging is the most common cause of this condition, according to the National Institutes of Health (NIH).
Other common causes of spinal stenosis that may require a laminectomy include:
- arthritis of the spine, including osteoarthritis and rheumatoid arthritis
- spinal injuries from motor vehicle accidents or falls
- herniated or slipped disks from aging or moving heavy objects
- tumors that grow inside the spinal canal
- bone spurs that grow into the spinal canal
Although a laminectomy can help relieve the painful symptoms of spinal stenosis, a doctor may initially recommend less invasive treatment options, such as physical therapy and medications.
However, they may recommend a laminectomy if the symptoms persist despite the person trying other forms of treatment.
A doctor or other healthcare provider will explain the specific preparation requirements during an appointment before the surgery.
Before laminectomy, a doctor may ask a person to:
- avoid smoking
- stop taking any blood-thinning medications
- avoid eating or drinking for several hours before the procedure
- get a back brace and other supportive devices for use in the home
- place clothes, food, utensils, and other necessary items in easily accessible places
Before the procedure, a person should tell their doctor if they:
- are currently taking any prescription or over-the-counter medications, vitamins, or supplements
- are pregnant or think they may be pregnant
- have allergies to any medications, anesthetics, or latex
A person will need to arrange transportation to and from the hospital. It is also a good idea to arrange for someone to help around the house for a few weeks after the surgery.
During the procedure, a surgeon will likely:
- disinfect and clean the skin where they will make the incision
- make a small cut in the skin
- move the skin, muscle, and ligaments away so that they can access the spinal column
- carefully cut away part or all of the lamina bones
- remove bone spurs or any broken or loose disk fragments
- correct any misaligned, fractured, or weak vertebrae by fusing two or more vertebrae
- close the incision with stitches
- cover the closed incision with gauze bandages
The surgeon may only complete some of the steps above in certain types of laminectomy.
Once a person wakes up after their surgery, the doctor may have them try walking on their own.
Some people can go home on the same day as their procedure, while others may need to stay in the hospital for 1–4 days.
During the next few weeks, a person should get plenty of rest and avoid:
- bending over or twisting the spine
- driving or operating heavy machinery
- lifting, pulling, or pushing heavy objects
- engaging in any strenuous exercise
During the recovery process, a person should remember to take any prescription medication as their doctor indicates.
A doctor or nurse will explain how to take care of the incision while it heals. Following these care tips can help the incision heal faster and prevent infections.
As with any form of surgery, laminectomy carries a risk of some side effects. These can include:
- blood loss
- wound pain
- muscle, ligament, or nerve damage
- an infection in the surgical site
- a blood clot in the legs
- difficulty breathing
- an allergic reaction to the anesthetic or medication
Although laminectomy procedures rarely lead to severe complications, nerve roots injuries and dural tears can occur. These are more common among older adults.
Cerebrospinal fluid (CSF) can leak out of tears in the dura mater, which is the thick membrane surrounding the spinal cord. A CSF leak is a serious issue that can lead to additional complications, including dizziness, headaches, and seizures.
Other potential complications associated with laminectomy procedures include:
- unsuccessful treatment, which can lead to recurring symptoms
- an infection in the surgical site
- damage to the nerves, muscles, or tendons that stabilize the spine
- postoperative back pain, especially after spinal fusion
According to the National Health Service (NHS), recovery will depend on a person’s fitness and activity levels before the surgery.
It usually takes around 4–6 weeks for a person to return to their normal level of mobility and function. However, this will depend on the severity of the condition and symptoms before the operation.
It may take up to 6 weeks for the general pain and tiredness following surgery to disappear completely.
Most people will feel ready to drive around 2–3 weeks after the operation. Many people are able to return to work after 4–6 weeks. However, if a person’s job involves a lot of driving, lifting heavy items, or engaging in other strenuous activities, they may need to be off work for up to 12 weeks.
Following laminectomy, a person will likely notice significant relief from many symptoms of spinal stenosis. However, there is a chance that the symptoms will return after the procedure.
Although laminectomy procedures have relatively low complication rates, some people may develop infections, spinal instability, or blood clots.
A doctor may recommend laminectomy for a person with spinal stenosis. This procedure involves the partial or complete removal of the lamina, which helps relieve pressure on the spinal cord.
Laminectomy procedures are safe and effective treatments for people who experience chronic back pain. However, older adults and people with chronic health conditions may have a higher risk of complications, such as dural tears, nerve injuries, and infections.
The recovery period may last anywhere from 2 months to a year.