What You Should Know About a Laminectomy

You may benefit from a laminectomy if you experience significant neck, back or leg pain related to a spinal complication. Minimally invasive laminectomies offer less post-operative pain and a faster recovery time than the traditional open laminectomy, but it’s important to understand your options and discuss the best care plan with your provider.

What Is a Laminectomy?

A laminectomy is a procedure that removes part of a spinal bone to create more space in the spine. Each vertebra in your spine is made up of two laminae, which protect the spinal cord and nerve roots. A laminectomy removes part or all of a lamina to relieve pressure on a nerve root. If you have a herniated disc, your surgeon may pair a laminectomy procedure with a discectomy to directly remove the source of the compression.

How Is a Minimally Invasive Laminectomy Different From an Open Laminectomy?

Traditional spine surgery or open laminectomy involves a larger incision, while a minimally invasive laminectomy involves smaller incisions and less ligament and tissue disruption. Surgeons use specialized tools during a minimally invasive laminectomy to minimize muscle and tissue disruption in the spine and the areas surrounding the spine.

What Is a Lumbar Laminectomy?

A surgeon performs lumbar laminectomies on the lumbar vertebrae, which are in the lower spine. A lumbar laminectomy involves a small incision in the lower back, and it can help relieve numbness or pain in the lower back and legs.

What Is a Cervical Laminectomy?

Surgeons perform cervical laminectomies on the cervical vertebrae, which are located in the upper spine or neck area directly below the skull. The cervical spine consists of seven vertebrae, and a minimally invasive laminectomy involves a small incision on the back of the neck.

What Can a Laminectomy Treat?

A surgeon may recommend a laminectomy to treat the following conditions:

• Spinal stenosis
• Herniated discs
• Bone spurs
• Tumors
• Abscesses
• Spinal deformities

Benefits of a Minimally Invasive Laminectomy

A minimally invasive laminectomy’s smaller incisions offer the following advantages:

• Less pain: Since a minimally invasive laminectomy has a lower impact on the muscles and tissues surrounding the spine, it typically results in less post-operative pain and a more comfortable healing process.
• Lower complication rates: Minimally invasive laminectomies have lower complication and reoperation rates.
• Shorter hospital stay: You can expect a shorter hospital stay after undergoing a minimally invasive laminectomy. If there are no complications following surgery, you may be able to return home the same day or one to two days after surgery.
• Faster recovery: You can expect to resume your regular daily activities and experience positive results faster after receiving a minimally invasive laminectomy.

Is a Minimally Invasive Laminectomy Right for You?

Doctors typically recommend nonsurgical treatments for severe neck, back or leg pain before recommending surgery. These treatments may involve injections, medication or physical therapy. However, a minimally invasive laminectomy is typically the best option if you meet some or all of the following criteria:

• Significant pain, numbness or weakness in the neck, back or legs
• Difficulty standing, walking or maintaining bladder or bowel control
• Symptoms that impact daily living and quality of life
• Symptoms that do not improve with conservative treatments
• Good overall health with no health conditions that could impact surgery
• Motivation to participate in an appropriate physical rehabilitation and recovery plan

You may require an open laminectomy if you have a complex spinal condition, infection, significant epidural scarring or significant spinal instability.

What You Should Know About a Laminectomy

Understanding the following factors can help you prepare for a minimally invasive laminectomy:

Preoperative Preparation

Before performing a laminectomy, your surgeon will ask you to undergo the following to ensure you are in good health for the procedure:

• A review of your medical history and a thorough physical examination
• Diagnostic imaging tests such as an MRI, X-ray and CT scan to identify your precise needs and plan the surgery
• Specific medication changes, such as avoiding anti-inflammatory medications and blood thinners, to reduce the risk of complications during surgery
• Lifestyle adjustments, such as avoiding smoking and alcohol consumption, before surgery
• Dietary changes the night before surgery

It’s also important to prepare your home and arrange for post-operative support before your procedure. Stock up on groceries and cook some easy-to-prepare meals so you have what you need while you heal. You can also remove loose rugs and declutter your home to avoid potential falls. Arrange for a friend or family member to transport you to and from your procedure, and ensure you have someone who can help with daily tasks during your recovery period.

What Happens During the Procedure?

A minimally invasive laminectomy takes place in the following steps:

1. You receive anesthesia so you’re asleep and unaware of the procedure as it occurs.
2. Your surgeon makes a small incision over your affected vertebrae.
3. The surgeon inserts a small cylindrical device known as a tubular retractor into the incision to gently access the spine.
4. A specialized instrument, such as a surgical microscope, or X-ray guidance, helps the surgeon locate the precise lamina to remove.
5. The surgeon carefully removes the affected lamina along with any tissues, thickened ligaments or bone spurs.
6. As the surgeon removes the tubular retractor, the tissues and muscles around the vertebrae settle back into place.
7. The surgical team uses surgical glue, sutures or staples to close the incision.

Recovery Time and Healing Tips

Following your provider’s instructions for your recovery period is crucial for proper healing. You may be able to resume normal daily activities a few weeks after surgery and achieve full recovery within a month or two, but this can vary based on your overall health and how your surgery goes. The surgeon may recommend the following tips to support your healing after a procedure:

• Taking medication as prescribed
• Resting
• Light walking and breathing exercises
• Avoiding prolonged sitting or standing
• Avoiding bending, heavy lifting and twisting
• Attending physical therapy after you reach a certain stage in healing
• Refraining from work and strenuous daily activities until your provider approves them

Potential Risks

Any surgery poses potential risks, so it’s important to discuss concerns with your provider and determine the best options for you. In some cases, a minimally invasive laminectomy can lead to the following complications:

• Infection
• Nerve damage
• Bleeding
• Blood clots
• Pain
• Tears in the membrane surrounding the spinal cord
• The need for additional surgery if the procedure doesn’t relieve pain
• Reactions to anesthesia

Choosing an experienced surgeon increases your chances of positive surgical outcomes. A provider with extensive experience in minimally invasive procedures has the skills and training to perform a laminectomy with precision. It’s also essential to discuss your expectations with the surgeon. Your specific condition and overall health can impact outcomes, so you should talk to your provider about your desired outcome and whether surgery is the best option.

What Is Post-Laminectomy Syndrome?

Post-laminectomy syndrome is a recurrent or persistent pain following a laminectomy. It can also involve numbness, tingling, stiffness or weakness. This is also known as a type of failed back surgery syndrome (FBSS).

What Can Cause Post-Laminectomy Syndrome?

The following factors can potentially cause you to experience continued pain after your procedure:

• Scar tissue that presses on nerves or the spinal cord
• Vertebrae slippage
• Residual disc herniation
• Spinal instability following surgery

Schedule a Consultation With Spine Institute of North America

Spine Institute of North America provides minimally invasive procedures to help you relieve pain and revive your life. Our spine specialists continually receive training and education from around the world, maintaining excellent skills and experience in the least invasive spine procedures. We use a patient-first, honest approach to address your pain and help you determine the best care options based on your needs. Contact us to learn more about our services or schedule a consultation.