Lumbar Laminectomy

Laminectomy

A lumbar laminectomy is a decompression surgery that removes part or all of the lamina, bone spurs, possible herniated disc, and arthritic ligaments.

The goal of the surgery is to enlarge the spinal canal, relieving pressure on the spinal cord and exiting nerves. A lumbar laminectomy is only considered once non-surgical treatment options have been exhausted.

Pinched or compressed nerves are common, affecting around 85 out of 100,000 people yearly. Continue reading to see how DISC can help.

Is a Lumbar Laminectomy a Major Back Surgery?

A lumbar laminectomy is a minimally invasive surgical option. While it does involve removing a small part of the spine called the lamina, most patients go home the same day or a short hospital stay.

Why Would Someone Need a Lumbar Laminectomy?

Boney overgrowth, due to arthritis of the spine can build up in the spinal canal causing narrowing of the spinal and compress the spinal cord. The pressure on the spine can cause numbness, weakness, or pain that can radiate down one or both legs. Any condition that puts immense pressure on nerves in the spinal cord could be relieved through a lumbar laminectomy.

Spinal arthritis or other conditions could cause:

  • Bone spurs: Bony growths on the vertebrae, causing pain by affecting nearby tissues and nerves.
  • Spinal stenosis: The narrowing of the spinal canal, restricting movement and putting pressure on nerves.
  • Bulging and herniated discs: Weakened and enlarged spinal discs increase pressure on surrounding nerves.
  • Pinched nerve: The force from an abnormal spine condition on a nerve, creating inflammation and pain.
  • Spinal tumor: An uncontrolled cell growth in or on the spinal cord, causing compression.
  • Degenerative disc disease: The wear and tear of spinal discs as a part of the aging process.

Benefits of a Lumbar Laminectomy

A lumbar laminectomy can solve various back pain issues. Some of its benefits involve:

  • Enhanced mobility A lumbar laminectomy can relieve, weakness, numbness and pain in one or both legs, encouraging longer periods of walking and standing.
  • Relieves symptoms involved with nerve symptoms Tingling in the legs or buttocks is a common symptom related to intense pressure on the spinal cord. Numbness and the “pins and needles” sensation in the lower extremities can be resolved.
  • Better quality of life – Overall, a lumbar laminectomy can allow the patient to return to their favorite activities, especially those including prolonged motion.
Doctors standing next to table of tools while working in the operating room

Lumbar Laminectomy Preparation and Pre-Op

Before the day of surgery, the patient should receive detailed instructions on the upcoming procedure. A doctor will request a physical examination, blood work and tests to ensure the patient can endure the surgery. Once cleared, consider the following tips to best prepare for surgery:

  • Collect all insurance information and keep it in one place. Having all of this together can make the surgery day go much smoother.
  • Confirm any driving arrangements and recovery assistance with a trusted friend or family member. The doctor may clear the patient to leave the same day of the surgery, so ensure travel and assistance plans are lined up.
  • Expect to be slower during the recovery period. To make it easier, prepare essential items — like kitchen supplies, a bed, and basic hygiene products — all on the house’s main floor.

On the day of surgery, an anesthesiologist will review the procedure with the patient and start an IV in your arm. The patient should state any current medications or preexisting health conditions that can interfere with the surgery. Your surgeon will also come and mark your surgical site and answer any last-minute questions and concerns. The patient will then be transported to the operating room.

What to Expect During Surgery

A lumbar laminectomy is done under general anesthesia, so the patient will be unconscious throughout the procedure.

As a minimally invasive procedure, the surgery will begin with a small incision over the affected vertebrae in the lower back. A metal dilator is first inserted under fluoroscopy (real-time X-ray) into the muscles and tissue down to the affected spinal level. Then a series of metal cannulas are placed on the dilator gently spreading the muscles. The dilator is then removed and a surgical portal is established by which your spine surgeon will perform their laminectomy.

The surgeon will use medical instruments to remove any bone spurs or a disc and the smallest amount of the lamina possible.

In the event you have a bulging disc the surgeon will sparingly decompress the disc relieving pressure on the spinal cord. In cases of degenerative disc disease or spinal instability, the surgeon will perform the laminectomy, remove the damaged disc and replace it with a bone graft, screws and rods, and a spinal fusion will occur.

The incision will then be closed off with stitches or surgical staples.

Potential Risks and Complications

A laminectomy is generally safe, but risks and complications are possible with any surgical procedure.

Some of these include:

  • Bleeding
  • Infection at the incision
  • Blood clots in the legs or lungs
  • Spinal fluid leak
  • Nerve root damage
  • Complications with general anesthesia

Post-Op Care and Recovery

Post-op and recovery can be different for each individual — below, see what this looks like on average.

In the Hospital

  • Medical professionals will monitor the patient’s blood pressure and heart rate as they come out of general anesthesia. Once they are stable, the patient will return to their hospital room. The doctor may clear the patient to go home the same day. However, it is typical for the doctor to recommend a one-night or longer stay to ensure the patient’s safety.
  • Nurses and on-site physical therapists will help the patient get up and walk starting the evening of their surgery. Once pain can be managed with oral pain medications and mobility is cleared, the patient can be discharged.

At Home

  • Doctors may send a gentle exercise plan home with the patient to encourage mobility and healing. The patient can shower at home but must be gentle when rinsing and pat the incision dry.
  • To manage pain and soreness, take only prescribed medications, as others can increase the risk of bleeding.
  • Light activities can resume in a day or two. Any strenuous movement like exercising, lifting or bending should be avoided for two to three months following surgery. Patients usually return to regular activities like driving in one to two weeks.
  • Avoid long periods of sitting — like flights or car rides — to decrease the chances of developing blood clots. Instead, get up and walk every hour to encourage blood flow.

Call a doctor if experiencing any of the following signs of complications:

  • Fever

  • Redness, swelling or leakage from the incision

  • Return of numbness or tingling in your legs or buttocks

  • Trouble urinating or significant loss of bowel control

Dr Abrams explaining spine x-ray Dr. Abrams laughing

Manage Back Pain with DISC

At Desert Institute for Spine Care, we are passionate about each patient’s quality of life. Contact us today to schedule an appointment or learn more about our treatment options. Let us help relieve the physical and emotional pressure of back pain.

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Our spine health blog features up-to-date spine education and expert spine tips from our spine specialists here at DISC.