Laminectomy is a type of spinal decompression surgery that removes the lamina—the back of the vertebrae which protect the spinal canal—in order to remove pressure on nerves or the spinal cord. People with spinal arthritis are especially likely to have bony overgrowths that constrict nerves.
Doctors will usually try non-operative interventions before suggesting a laminectomy. But if approaches like physical therapy, injections and medications fail—and especially if patients are experiencing severe consequences, such as difficulty walking or loss of bladder or bowel control—this surgery might help. Laminectomy is most effective for patients whose compressed nerves are causing pain to radiate down their legs or arms. Since the procedure provides more space in the spinal canal but doesn’t cure arthritis, it’s more useful in decreasing leg and arm pain than in relieving back pain.
The patient will be under general anesthesia for the laminectomy. The surgeon cuts an incision in the back over the troubled vertebrae. The size of the incision will depend on how many vertebrae are affected. The surgeon uses small instruments to remove the lamina. Often this surgery is combined with other procedures, such as removal of a herniated disc or a spinal fusion. The latter may be necessary if a vertebra has slipped and is overlapping the adjacent bone.
Many people are able to go home the same day after a laminectomy. Some patients will need to stay overnight, especially if the surgery was more complicated. The doctor will prescribe pain medication if needed, and may recommend physical therapy. Patients need to take some time off work. If the job is less physically demanding, the patient may be able to return to work within a few weeks. Recovery time will be longer if the laminectomy was paired with spinal fusion.
Laminectomy is considered safe, but surgery always carries the risk of complications. These could include blood clots, nerve injury, bleeding, infection and spinal fluid leak.