Laminectomy, also called decompression, is surgery to remove the lamina — the back part of the vertebra that covers your spinal canal. Laminectomy enlarges your spinal canal, relieving pressure on the spinal cord or nerves caused by narrowing of the spine (spinal stenosis). Laminectomy may also be performed as part of surgical treatment for a herniated disk.

Laminectomy is not necessary for everyone who has spinal stenosis. Laminectomy usually is used when more conservative treatment, such as medication and physical therapy, has failed to relieve symptoms, or when symptoms are severe.

In some cases, laminectomy may be performed in conjunction with spinal fusion, a procedure that helps stabilize your spine.

Laminectomy Candidates

Spinal Stenosis

Laminectomy is performed to relieve the pressure spinal stenosis places on your spinal cord or spinal nerves.

Your doctor may recommend laminectomy if:

• Conservative treatment, such as medication or physical therapy, fails to improve your symptoms after 12 weeks
• You have muscle weakness or numbness that makes standing or walking difficult
• You experience loss of bowel or bladder control

Disk Herniation

In some cases, laminectomy may be necessary as part of surgery to treat a herniated spinal disk. Your surgeon may need to remove part of the lamina to gain access to the damaged disk.

Laminectomy Outcome & Benifits

Laminectomy reduces symptoms in 60 to 90 percent of people who undergo the procedure due to spinal stenosis. Most have less pain and are better able to walk following laminectomy. You might not notice improvement right away, though. It can take up to six weeks after surgery to start feeling a reduction in your symptoms. If your nerves were badly damaged before surgery, some pain, numbness and other symptoms may not go away.

Because laminectomy doesn't stop the process that caused spinal stenosis in the first place, symptoms may come back over time. One study found that approximately 19 percent of people who had laminectomy underwent repeat surgery within 10 years of the initial procedure.

Prepare for Laminectomy

You may need to avoid eating and drinking for a certain amount of time before surgery. Your doctor will give you specific instructions.

Laminectomy Surgery Overview

Surgeons usually perform laminectomy using general anesthesia, so you're unconscious during the procedure. The anesthesiologist or anesthetist gives you an anesthetic medication as a gas — to breathe through a mask — or injects a liquid medication into a vein.

The surgical team monitors your heart rate, blood pressure and blood oxygen throughout the procedure with a blood pressure cuff on your arm and heart-monitor leads attached to your chest. After you're unconscious:

1. The surgeon makes an incision in your back over the area of your spine affected by stenosis and moves the back muscles away from your spine as needed.
2. Small instruments are used to remove the lamina covering the areas affected by spinal stenosis.
3. If laminectomy is being performed as part of surgical treatment for a herniated disk, the surgeon also removes the herniated portion of the disk and any pieces that have broken loose (diskectomy).
4. If one of your vertebrae has slipped over another or if you have curvature of the spine, spinal fusion may be necessary to stabilize your spine. During spinal fusion, the surgeon permanently connects two or more of your vertebrae together using bone grafts, and if necessary, metal rods and screws.
5. The surgeon closes the incision using staples or stitches.

In some cases, your surgeon may use a laparoscopic technique to perform laminectomy, rather than open surgery performed through one larger incision. In laparoscopic laminectomy, a tiny camera and surgical instruments are inserted through several small incisions, and your surgeon views the operation on a video monitor. Laparoscopic back surgery is complex and requires great skill. It's not available at all hospitals. You may not be a candidate for laparoscopic laminectomy if you have a herniated disk or spine instability.

Laminectomy Recovery

After surgery, you're moved to a recovery room where the health care team watches for complications from the surgery and anesthesia. Your doctor may prescribe medication to relieve pain at the incision site.

You may go home the same day you have surgery, although in some cases a hospital stay of one to three days may be necessary following laminectomy. Your doctor may recommend physical therapy after laminectomy to help you regain your strength.

Limit activities that involve lifting, bending and stooping for three weeks after laminectomy. You may also need to avoid long car rides for at least four to six weeks. Depending on the amount of lifting, walking and sitting your job involves, you likely will be able to return to work within two to six weeks.

If you also had spinal fusion, your recovery time may be longer. In some cases after laminectomy and spinal fusion, it may be eight to 12 weeks before you can return to your normal activities.

Laminectomy After Care

Aftercare following a laminectomy begins in the hospital. Most patients will remain in the hospital for one to three days after the procedure. During this period the patient will be given fluids and antibiotic medications intravenously to prevent infection....

Medications for pain will be given every three to four hours, or through a device known as a PCA (patient-controlled anesthesia). The PCA is a small pump that delivers a dose of medication into the IV when the patient pushes a button. To get the lungs back to normal functioning, a respiratory therapist will ask the patient to do some simple breathing exercises and begin walking within several hours of surgery.

Aftercare during the hospital stay is also intended to lower the risk of a venous thromboembolism (VTE), or blood clot in the deep veins of the leg. Prevention of VTE involves medications to thin the blood and wearing compression stockings or boots.

Most surgeons prefer to see patients one week after surgery to remove stitches and check for any postoperative complications. Patients should not drive or return to work before their checkup. A second follow-up examination is usually done four to eight weeks after the laminectomy.

Patients can help speed their recovery by taking short walks on a daily basis; avoiding sitting or standing in the same position for long periods of time; taking brief naps during the day; and sleeping on the stomach or the side. They may take a daily bath or shower without needing to cover the incision. The incision should be carefully patted dry, however, rather than rubbed.

When You Return Home

You can do several things to make your recovery at home easier. Move groceries, toiletries, and other supplies to places between the level of your hip and shoulder where you can reach them without bending over.

Make sure someone can drive you around for 1-2 weeks after surgery and to help with chores and errands. Buy a pair of slip-on shoes with closed backs to make dressing easier and to minimize bending over.

Short frequent walks each day may reduce your pain as well as speed your recovery. Normally, if you have a sedentary job, you may return to work in 1-2 weeks. A person with a more strenuous job may have to remain off work for 2-4 months.

As your back heals, you may feel ready to have sex. This is normally fine. Choose a position that puts as little pressure on your back as possible. Side positions or lying on your back are generally acceptable. Avoid putting pressure on your back or arching your back during sex.

Do not drive a car for 1-2 weeks, or as long as you are taking any medication that makes you drowsy.

Laminectomy Possible Risks

Laminectomy is generally a safe procedure. But as with any surgery, laminectomy carries a risk of complications.

Potential complications include:

• Bleeding
• Infection
• Blood clots
• Injury to blood vessels or nerves in and around the spine
• Injury to the protective layer surrounding the spine (dura mater)