What is a laminectomy?
A laminectomy is a type of spinal decompression surgery that removes part of the bone in your spine, called the lamina. The lamina acts as a protective covering for your spinal nerves and spinal cord. Removing it helps reduce pressure on your nerves and spinal cord by creating more space in the spinal canal (the tunnel where your spinal cord and nerves reside).
This surgery is most often done in the lower back (lumbar laminectomy) to relieve nerve pain, but can also be performed in the neck (cervical laminectomy) or upper back (thoracic laminectomy) to ease nerve compression, also known as stenosis, in those areas.
Who is a good candidate for a laminectomy?
You may be a good candidate for a laminectomy if you have ongoing back or neck pain that hasn’t improved with other treatments. This surgery helps relieve symptoms like arm or leg pain and numbness caused by pressure on the nerves in your spine.
Your doctor may recommend a laminectomy if you're experiencing neck, shoulder, or back pain, weakness or numbness in your arms or legs, or problems with fecal incontinence or urinary incontinence.
Laminectomy can be used to treat:
- Herniated discs
- Spinal stenosis
- Sciatica
- Spinal injuries
- Metastatic spinal cord compression
- Spinal tumors
How to prepare for a laminectomy
Before your surgery, your surgeon may order imaging tests to help plan your surgery or determine whether you have a condition, such as spondylolisthesis or scoliosis, that may make a laminectomy less than ideal.
Once you’ve decided to proceed, your doctor may recommend:
- Changes to your medications: You may need to stop certain medications or start new ones to help reduce your risk of complications.
- Planning for a hospital stay: You may be able to return home the same day as your procedure, but your surgeon may have you stay in the hospital for one to two days.
- Preoperative care: This helps ensure you’re as healthy as possible for surgery. It may involve physical therapy or managing chronic conditions, such as diabetes.
- Preparing your home: You may want to cook meals ahead of time or move your living space to a lower floor.
- Quitting smoking: Smoking can slow your recovery and increase your risk for complications.
The laminectomy surgery
Surgeons can perform a laminectomy in one of two ways.
During an open laminectomy, they will make a single large incision to access and remove the lamina. During minimally invasive laminectomies, they make a single small incision and use a tool called a tubular retractor that pushes muscle aside, so the surgeon doesn’t have to cut through it. The surgeon uses imaging to know where to place the retractor and inserts small instruments into it to perform the procedure. Your specific spinal condition will determine which techniques are the best for you, and a discussion with your surgeon will help make that decision.
Depending on your diagnosis, you may have a laminectomy with spinal fusion or a discectomy procedure.
Before surgery
Follow the instructions your surgeon gave you. You likely will need to stop eating or drinking for six to 12 hours before surgery, generally beginning at midnight before surgery, and take medications as instructed.
Arrive at the hospital at the time your surgical team provided.
Laminectomies are done under anesthesia, so you will meet with your anesthesiologist before surgery to learn what to expect. You may receive general anesthesia, which puts you to sleep, or regional anesthesia, which numbs an area of your body.
During surgery
Your surgery will begin with your surgeon making a cut in your neck, mid-back or lower back, depending on which type of laminectomy you’re having. Next, your surgeon will move muscle and other tissues to the side to see your spine and access the lamina.
The surgeon will remove the lamina in one or more of your vertebrae. In some cases, they may remove only part of the lamina. The surgeon may also remove bone spurs, pieces of a herniated disc or other tissue putting pressure on your nerves or spinal canal.
Finally, the surgeon will move the muscle and tissues back into place and close the incision.
After surgery
In the hospital
After surgery, you’ll be monitored in the recovery room until your vital signs are stable. Once you're alert, you’ll be moved to your room. You may stay in the hospital for one or more days, depending on your surgery, though smaller surgeries may permit you to go home the same day.
You'll likely begin walking the same evening, with pain controlled by medication. You may also receive an exercise plan to follow during your stay and after discharge.
At home
Keep your incision clean and dry, following your provider’s bathing instructions. Staples or stitches will be removed, if necessary, at a follow-up visit.
Take pain medication as directed, avoiding aspirin, ibuprofen, NSAIDs, supplements or other medications that may increase bleeding.
Contact your healthcare provider if you experience:
- Fever
- Redness, swelling or drainage from the incision
- Increased pain near the incision
- Numbness in your legs or back
- Difficulty urinating or controlling your bladder or bowels
Avoid driving until cleared by your provider and refrain from bending or arching your back, lifting or twisting. Your provider may also give specific activity restrictions based on your recovery.
What are the risks of a laminectomy?
All surgeries carry some risks.
One potential risk of laminectomy procedures is failed back surgery syndrome (FBSS), which may also be referred to as post-laminectomy syndrome. FBSS can occur if the surgery on your lower back didn’t address your back pain or if you develop back pain after surgery. Many factors can contribute to FBSS, including scar tissue that forms after surgery.
Other laminectomy complications include:
- Bleeding
- Blood clots (deep vein thrombosis)
- Damage to nerves
- Infection
- Spinal fluid leak
- Reactions to anesthesia
- Spinal instability
Laminectomy recovery
Your recovery time depends on the type of surgery you had. After a laminectomy, most people recover in about four to six weeks. If you had a laminectomy with spinal fusion, full recovery may take up to six months.
Everyone heals at their own pace. In the beginning, take it easy and avoid bending, lifting or twisting. Gradually increase activity as you feel able and follow your healthcare provider's advice.
Staying active will help you heal faster, so follow your physical therapy exercise plan. Avoid staying in one position for too long to reduce stiffness and soreness. Walking is a great way to stay active, and you should work up to walking 30 minutes or more a day. Avoid heavy lifting and awkward movements until you feel stronger and are cleared to do so.
You'll have follow-up appointments to check your progress. Most people return to work within four to eight weeks if their job isn’t too physical. For more strenuous jobs, you might need up to three to six months.
Before driving again, make sure you’re not taking any painkillers that make you drowsy, and that you’re comfortable in the driver’s seat. Most people can start driving again within two to six weeks.
Frequently asked questions
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How long is laminectomy surgery?
Laminectomies generally take between one to three hours, but that depends on the type you’re having, how complex your surgery is, and whether you’re having other procedures, such as fusion or discectomy, at the same time.
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How long does it take to recover from a laminectomy?
Laminectomy recovery depends on whether you had other procedures at the same time. With laminectomy alone, you can generally return to daily activities within four to six weeks, but it may be a few months before you’re fully recovered.
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Is a laminectomy a major surgery?
Yes, a laminectomy is considered major surgery. It involves removing part or all of the lamina, the bony area around the spinal cord. This procedure is usually only recommended when other treatment options haven’t provided relief, as it’s more complex and carries some risks. Although it is a major surgery, it is still considered one of the less complex and less involved spine surgeries.
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How long does a laminectomy last?
A laminectomy typically takes about one to three hours, though the exact time can vary depending on your specific needs and the complexity of the procedure.
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How soon can you walk after a laminectomy?
Most people are able to walk a few hours after a laminectomy. At first, you may need some help with standing, sitting or walking as you start to recover.