A laminectomy is a procedure where the entire bone that makes up the roof of the spine, the lamina, is removed. An incision is made in the midline of your back at the affected area. The muscles in this area are dissected to the sides and the entire lamina is removed. This can be done at multiple levels if necessary. Any disc material, thickened ligaments, or bone spurs compressing the nerves are also removed. This effectively takes the pressure off of all the nerves at that level and is typically done to relieve symptoms of lumbar stenosis.
A lumbar microdisectomy, or a procedure to remove a herniated disc, may be done at the same time as a lumbar laminectomy.
Who is a good candidate for this procedure?
Candidates for lumbar laminectomy and discectomy are those with worsening pain, numbness, tingling or weakness in the legs from a herniated disc or from degenerative bone spurs causing stenosis. It is important that each patient is carefully screened by a qualified surgeon to determine the most appropriate treatment.
Anatomy
The lumbar spine, or low back, includes the five largest and strongest vertebrae. Between each vertebra is a gel-filled disc that acts as a shock absorber, providing a cushioning effect to absorb pressure and distribute stress. If this disc is ruptured or not working properly due to degeneration, it can put pressure on the nerves and cause pain. The lamina of each vertebra is the bone that forms the back of the spinal canal. The foramen is a small opening where the nerve leaves the spinal canal.
When is surgery recommended?
If you have worsening back or leg pain or weakness resulting from stenosis that limits your everyday activities, and conservative methods of treatment have failed, you should consider lumbar laminectomy.
What is the recovery time?
After a laminectomy, depending on the number of levels that needed to be decompressed, patients may go home the same day or stay overnight for observation. Patients are typically walking soon after surgery and go home the next day. A physical therapy program may be necessary to rehabilitate back and leg muscles. Many people are able to resume work and daily activities within a couple of weeks. Those with physically demanding jobs that include lifting and operating heavy machinery may have to wait longer to return to work.