Every year more than 700,000 Americans seek surgery for back pain. Training before surgery can speed up your recovery.
What is a laminectomy?
It is surgery of the lumbar spine to decompress the spinal nerves in the lower back to relieve hip and leg pain caused by spinal stenosis, including sciatica. This procedure is also appropriate to remove bone spurs and ligaments that are pinching nerves and causing pain; for herniated discs causing leg pain, and for a slipped vertebra. It is the most common type of back surgery. The goal is to widen the spinal canal to alleviate pressure on the cord or the spinal nerves.
A laminectomy may be performed with a spinal fusion or not. A spinal fusion is intended to support the lumbar spine by fusing of the affected vertebrae, and/or removing part of a spinal disc. Metal rods and screws may be used to support fusion in unstable parts of the spine. Fusion is believed to prevent re-stenosis and reduce pain caused by unstable areas.
What is lumbar spinal stenosis?
It is an age-related degenerative condition that results from the thickening and hardening of spinal ligaments which narrow the spinal canal compressing spinal nerves that cause pain, numbness and weakness in the legs. Stenosis can result in enlargement of the facet joints in the back of the vertebrae, usually due to bony overgrowths caused by arthritis of the spine. Also the bones and joints may enlarge, and bone spurs can form. Narrowing of the spinal canal puts pressure on the spinal cord. The vast majority of spinal stenosis is due to the gradual wear and tear of everyday activities, and often involves arthritis of the spine.
What is the lamina?
The lamina is the small flat bones that cover the nerve roots. The lamina protects the spine, the nerve roots that branch off of the spine and the nerve roots that exit the spine.
Indications for a laminectomy
- Spinal stenosis with leg pain, numbness or weakness that makes it difficult to walk without tightness, cramping or heaviness in the buttocks and thighs.
- Sciatica, a sharp shooting pain that extends from the buttocks to the thigh and down the leg
- Osteoarthritis of the spine
- Degenerative disc disease
- Herniated discs
The laminectomy procedure (open decompression)
The procedure is also called open decompression and requires a 2-5 inch incision along the midline of the back. The spinal muscles are moved off of the lamina, the lamina is removed,
and the surgeon can see the nerve roots. The surgeon will remove bone, ligaments and bone spurs that are compressing the nerves. The facet joints lie directly over the nerve roots and may be trimmed to allow more space for the nerves. When all the pressure points have been removed, the muscles are sewn together.
The patient is usually hospitalized for 1-3 days. Sometimes the fusion of the spine can improve the success rate of a laminectomy. Spinal fusion is designed to stabilize the spine.
One of the best things you can do for yourself is to quit smoking
Smoking affects your blood circulation and wound healing. Smokers have an increased risk of back pain! Smoking accelerates degenerative disc disease. Smoking increases the risk of complications.
Smokers have an increased risk of wound healing problems and infections. The nicotine in cigarettes, gums or patches affects bone healing. Patients are advised to give up smoking including e-cigarettes.
Pain and discomfort will improve every day. And note that recovery is different for everyone. Staying healthy, eating well, resting and having a positive attitude can help shorten recovery time.
- Normal risks of anesthesia
- Nerve root damage
- Spinal fluid leak
- Blood clots
- Postoperative spinal instability
After surgery, 70-80% of patients will find significant improvement in function and reduced discomfort, especially for sciatica caused by spinal stenosis.
Surgery does not eliminate the continual degeneration of the spine.
A laminectomy may be recommended if conservative treatments have failed to improve the pain, numbness and weakness that radiates down the leg. A laminectomy is better at relieving pain in the buttocks and leg, rather than back pain. This surgery may be recommended when a patient has muscle weakness or numbness that makes standing or walking difficult. And when the patient experiences a loss of bladder or bowel control due to spinal stenosis, a laminectomy is the procedure of choice.