Lumbar Laminectomy

What is Laminectomy?

Laminectomy is a surgical procedure involving removing part of the vertebral bone called the lamina.
The lamina is a flat, thin vertebral arch component covering the spinal cord and nerves.

Laminotomy is a similar procedure, but here only a part of the lamina is removed to create a window.

Why is it done?

Generally, laminectomy is carried out to ease the pressure on the spinal cord or spinal nerves that results from conditions like spinal stenosis, spinal tumours, or herniated discs.

The narrowing of the spinal canal can compress the spinal cord and nerves, leading to various symptoms, including pain, numbness in the lower back, hips, legs, and feet and, rarely, weakness. The severity of these symptoms depends on the extent of the stenosis.

Unfortunately, non-surgical treatments such as medication, physiotherapy, injections, or manipulation are unlikely to offer long-term relief. The symptoms hardly ever improve permanently without decompression surgery to alleviate nerve pressure.

What happens during the procedure?

Before the procedure, the patient will typically undergo a thorough evaluation by the surgeon to determine the underlying cause of their pain and whether a lumbar laminectomy is an appropriate treatment option. This will also include an anaesthetic assessment for fitness for surgery.

The surgery is usually performed under general anaesthesia, and the patient lies face down on the operating table.

The surgeon makes a midline incision in the lower back over the affected disc's area.

The surgeon then uses a microscope/ surgical loupes and specialized instruments to remove the portion of bone that is compressing the spinal nerves. Magnification has its advantages like enhanced visualisation, improved precision, reduced trauma, and quicker recovery (reduced trauma and small incisions).

Surgery aims to remove the material (for example, the excess bone and ‘thickened’ ligament) from the back of the spinal canal to give the nerve roots and/or cauda equina more room.
The procedure typically takes one or more hours, depending on the extent of the stenosis and the case's complexity.

Typically, approximately 70-80% of patients experience good relief from leg pain after decompression surgery, which may take several weeks to take effect.

Spinal surgery is not a complete solution and cannot prevent further degeneration of the disc. Its goal is to provide benefits with a good percentage improvement and relief of leg symptoms. However, in some cases, numbness or weakness may persist even after a technically successful operation.
It should be noted that the surgery is not aimed at relieving back pain, and its success rate in this regard is less reliable.

What happens after the procedure?

After the procedure, the patient is taken to a recovery room, where they are monitored briefly before discharge. Patients can usually return home after safely mobilising following the surgery. This may be a day or a couple of days, depending on the case's complexity.

If necessary, physical therapy is typically initiated after the surgery to enhance the patient's strength and flexibility.

What are the potential side effects of the procedure?

As with any form of surgery, there are risks associated with it. These are nerve root damage, dural tear, recurrence, bleeding, infection, and ongoing pain.
These risks and benefits will be discussed in detail during the consent process.

Please follow the BASS (British Association of Spinal Surgeons) website for more information.

Learn more about condition:

Lumbar Canal Stenosis: Discover the causes, symptoms, and complications associated with Lumbar Canal Stenosis.