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Definition

A laminectomy is a surgery to remove a small portion of a vertebra. Vertebrae are the bones of the spine. The part removed is called the lamina.

In some cases, only a portion of the lamina is removed from the vertebra. The part removed is above and below a pinched nerve. This procedure is known as laminotomy.

Laparoscopic Laminectomy
Laparoscopic Laminectomy
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Reasons for Procedure

A laminectomy is usually done to help take pressure off your spinal cord or a nerve running out from your spinal cord. It is also done to gain access to the spinal cord, bones, and discs that are below the lamina. Ruptured discs , bony spurs, or other problems can cause narrowing of the canals that the nerves and spinal cord run through. This can irritate the nerve if it gets too narrow. Often, a laminectomy is done along with a disk removal to help make the canal larger and take pressure off the nerve being irritated.

When the spinal cord or other nerves get irritated, they can cause:

  • Weakness
  • Numbness
  • Pain in an arm or leg

Physical therapy and medication will be tried first.

The surgery is done when other treatments have not worked. It is most often done to treat symptoms that keep getting worse.

Possible Complications

Complications are rare, but no procedure is completely free of risk. If you are planning to have a laminectomy, your doctor will review a list of possible complications, which may include:

  • Infection
  • Bleeding
  • Blood clots
  • Damage to nerves, resulting in pain, numbness, tingling, or paralysis
  • Problems related to anesthesia

Factors that may increase the risk of complications include:

  • Another medical condition, particularly heart or lung problems
  • Obesity
  • Increased age
  • Smoking

Be sure to discuss these risks with your doctor before surgery.

What to Expect

Prior to Procedure

Your doctor may do the following:

  • Physical exam
  • X-ray —to take a picture of the bones of the backbone
  • MRI scan —to take pictures of the spinal cord to assess any damage
  • Myelogram —to show the structure of the spinal cord to see if there is pressure on the cord or the nerves
  • CT scan —to take pictures of the backbone

In the time leading up to your surgery:

  • If you are overweight, try to lose weight . This will decrease the amount of stress on your back.
  • Talk to you doctor about your medications. You may need to stop taking aspirin or other anti-inflammatory drugs for one week before surgery. You may also need to stop taking blood thinners.
  • Arrange for a ride home and for help at home.
  • Eat a light meal the night before. Avoid eating or drinking anything after midnight.

Anesthesia

Possible types of anesthesia for this operation include:

  • General anesthesia —blocks pain and keeps you asleep during the surgery; given through an IV in your hand or arm
  • Spinal anesthesia —numbs the area from the chest down to the legs; given as an injection in your back

Description of the Procedure

If the surgery is done with minimally invasive techniques, you will only need a few small incisions. A scope and small instruments will be inserted into these incisions. The lamina will then be removed using a drill or other tools. After the lamina is removed, the spinal cord and discs that were hidden under the lamina will be inspected.

In some cases, open surgery will be done. This involves making a larger cut in the skin over the area in the back.

The disc often needs to be removed as well to take pressure off the spinal cord. If it is not a disc problem, other problems causing the nerve irritation will be fixed. In rare cases, a spinal fusion may be done. A spinal fusion will involve joining two vertebrae. Lastly, the incision will be closed with stitches or staples.

Laparoscopic Removal of Disc Tissue
laparoscopic discectomy small
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How Long Will It Take?

1-3 hours

How Much Will It Hurt?

You will have pain during recovery. Your doctor will give you pain medication.

Average Hospital Stay

This surgery is done in a hospital setting. The usual length of stay is 1-3 days. Your doctor may choose to keep you longer if there are complications.

Post-procedure Care

At the Hospital

While you are recovering at the hospital, you may receive the following care:

  • You will have to walk with assistance the evening after surgery or the next day.
  • You may need to wear a back or neck brace.
  • You may need to wear special socks or boots. These will help to prevent blood clots.
At Home

When you return home, do the following to help ensure a smooth recovery:

  • Be sure to follow your doctor's instructions .
  • Keep the incision area clean and dry.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • Exercise your legs while in bed. This is to improve circulation and decrease the risk of blood clots.
  • Do not lift anything heavy.
  • Work with a physical therapist. You will slowly progress from walking to other low-impact activities, like swimming.
  • Only take medication advised by your doctor. Ask your doctor before taking any over-the-counter medication.
  • Have the stitches or staples removed in two weeks.

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
  • Nausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which persist for more than two days after discharge from the hospital
  • Pain that you cannot control with the medicines you have been given
  • Cough, shortness of breath, chest pain
  • Trouble urinating or having a bowel movement
  • New numbness or weakness in the hips, groin, or legs
  • Joint pain, fatigue, stiffness, rash, or other new symptoms

In case of an emergency, call for medical help right away.

Revision Information

  • American Academy of Family Physicians

    http://familydoctor.org

  • National Institute of Neurological Disorders and Stroke

    http://www.ninds.nih.gov

  • College of Family Physicians of Canada

    http://www.cfpc.ca

  • Health Canada

    http://www.hc-sc.gc.ca

  • Allen RT, Garfin SR. The economics of minimally invasive spine surgery: the value perspective. Spine. 2010 Dec 15;35(26 Suppl).:S375-82.

  • Djurasovic M, Glassman SD, et al. Contemporary management of symptomatic lumbar spinal stenosis. Orthop Clin North Am. 2010 Apr;41(2):183-191.

  • Herniated disc. American Association of Neurological Surgeons website. Available at: http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Herniated%20Disc.aspx. Updated December 2011. Accessed November 25, 2013.

  • Lindström D, Azodi O, et al. Effects of a Perioperative Smoking Cessation Intervention on Postoperative Complications: A Randomized Trial. Ann Surg. 2008 Nov;248(5):739-745.

  • Pain: hope through research. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/chronic%5Fpain/detail%5Fchronic%5Fpain.htm#Treatment. Updated August 30, 2013. Accessed November 25, 2013.

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