Home | Procedures | Laminectomy
By Dr Swetha Pendyala
Consultant Neurosurgeon
Published on 20 September 2022

Article Context

  1. Overview
  2. Procedure
  3. Risks
  4. Care at Medicover
  5. Frequently Asked Questions

Overview

Pain in the back or neck pain that interferes with normal daily activities may necessitate surgery. Laminectomy is a procedure in which a surgeon removes some or all of the vertebral bone (lamina) that helps to relieve pressure on the spinal cord or nerve roots caused by an injury, herniated disc, narrowing of the canal (spinal stenosis), or tumors. A laminectomy is considered only when all other medical treatments have failed. A disc may become displaced or damaged due to an injury or normal wear and tear. A disc presses on the spinal nerves and causes pain, numbness, or weakness.

Spinal pain can limit your ability to move and function. The numbness or pain will be felt in the body part innervated by the nerve, which is usually the arms or legs. Sciatica is a familiar symptom of a herniated disc. This sharp, shooting pain runs from the buttocks to the thigh and down the back of the leg.

Laminectomy may be performed to relieve spinal nerve pressure, treat a disc problem, or remove a tumor from the spine.

If medical therapy is no longer working, surgery may be a choice. Some medical treatments for pain may include:

  • Changes in physical activity
  • Smoking cessation
  • Medications such as muscle relaxants, anti-inflammatory medicines, and pain relievers.
  • Physical therapy
  • Spinal injections
  • Occupational therapy
  • Weight loss
  • Assistive devices, such as mechanical back supports

Indications

A laminectomy may be recommended if you have any of the following conditions and conservative or non-surgical treatments such as physical therapy and corticosteroid injections have failed to provide relief. The conditions include:

  • Herniated disc
  • Degenerative disc disease
  • Sciatica
  • Spinal stenosis
  • Spondylosis

Procedure

Before the Procedure

  • The doctor will note down a complete medical history and do a physical examination to ensure that you are healthy to undergo the operation.
  • You may have blood tests, urine tests, neurological evaluation, leg rise tests and other diagnostic tests such as x ray, CT, MRI and EMG.
  • Inform the doctor if you are sensitive to or are allergic to any medicines, latex, tape, anaesthesia medicines.
  • Tell your doctor of all prescribed and over-the-counter medicines and herbal supplements that you are taking.
  • Inform the doctor if there is a history of bleeding disorders or if you are taking any medications such as blood thinners. You may be told to stop the medicines before the procedure.
  • Before the surgery, you may need to meet with a physical therapist to discuss rehabilitation.
  • You have to avoid eating or drinking a few hours prior to surgery. A pre-medication injection is usually given to make you drowsy and dry up some internal secretions.

During the Procedure

  • An intravenous line will be initiated in the arm or hand.
  • Once you are under anaesthesia, a urinary drainage catheter will be inserted.
  • If the surgical site is covered with hair, the hair may be clipped off.
  • On the operating table, you will be positioned on your side or belly.
  • During the surgery, the anaesthesia specialist will monitor your heart rate, blood pressure, breathing, and blood oxygen level.
  • The skin over the planned surgical site will be cleaned with an antiseptic solution.
  • The surgeon makes an incision over the selected area of the vertebra.
  • The surgeon will separate the muscles.
  • The surgeon then removes the bony arch of the back part of the vertebra (lamina) to ease the pressure on the nerves in that area. This may involve removing bone spurs or growths, or removing all or part of a disc.
  • Spinal fusion may be performed simultaneously in some cases. The surgeon will connect two or more bones in your spine during a spinal fusion.
  • The incisions are closed with stitches or surgical staples.
  • A sterile bandage or dressing will be applied.

After the Procedure

  • You will be taken to the hospital room once your blood pressure, pulse, and breathing are stable and you are alert. Laminectomy usually necessitates a hospital stay of one or more days.
  • It is critical to keep the surgical incision area clean and dry once you return home. Bathing instructions will be provided to you. During a subsequent hospital visit, the surgical staples or stitches are removed.
  • Take pain medication and antibiotics for soreness as recommended by your doctor. Your doctor may recommend physical therapy after a laminectomy to improve your strength and flexibility.
  • Limit activities that involve lifting, bending and stooping for several months after laminectomy. You can go back to work depending on how much lifting, walking and sitting your job requires.

Benefits

The main advantage of laminectomy is that it relieves pressure and, thus, the symptoms caused by it. Most healthy people recover quickly and can walk within two days of surgery.

Risks

The complications have been associated with this procedure are:

Care at Medicover

The spinal cord of the nervous system is crucial because it gives the body shape, stability, and structure while allowing nerves to branch out to different body parts. Our surgeons are experts in evaluating and treating the most challenging and complex spinal conditions. Our medical expertise, combined with the availability of advanced medical technology for the diagnosis and treatment of spinal disorders and an excellent team of doctors ensure that you get the best possible outcomes.

Frequently Asked Questions:

The large, powerful back muscles provide adequate protection for the nerves below. So your spinal nerves will remain safe and secure following laminectomy.

You are encouraged to walk and move around the day after surgery, and you will most likely be discharged after 1 to 4 days. It will take you 4 to 6 weeks to regain your normal level of mobility and function.

Lower limb pain is very common 2-4 days after surgery and again after 3 weeks. This pain is usually mild than the pain you were experiencing prior to surgery, but it can be severe and stressful in some cases.

In general, you should expect to start physical therapy 4 to 6 weeks after your lumbar laminectomy or discectomy. If there are any postoperative complications like infection or excessive bleeding, then you may need to wait a bit longer.

L4 L5 laminectomy is a surgical procedure in which a surgeon removes some or all of the lamina of vertebral bone. It reduces pressure on the spinal cord or nerve roots caused by an injury, herniated disc, spinal stenosis, or tumours.

Some patients who had laminectomy surgery will develop new numbness or weakness in one or both legs as a result of the operation. Paralysis is a rare complication that can occur as a result of laminectomy.

When two or more vertebrae are damaged and a lot of bone has been removed, the vertebrae may become unstable or go out of alignment causing pressure on the nerves and severe pain. A spinal fusion surgery fuses adjacent vertebrae using bone from the hip as a graft to bridge the gap. Plates and rods may be used to stabilise the spine and protect the graft while it uptakes.

Sitting in a recliner chair with your legs raised and upper back propped up may help alleviate some of your discomfort. If you don't have a recliner, you can achieve a similar effect by placing pillows beneath your legs and behind your back.

References