Laminectomy Overview

Click here to view an animated version of this procedure.

This is a surgery to remove a small portion of a vertebra (back bone). The part removed is called the lamina.

Ruptured Disc in Neck Pushing on Nerves © 2009 Nucleus Medical Media, Inc.

Prior to Procedure

Your doctor may do the following:

• Physical exam
• X-ray —a test that uses radiation to take a picture of structures inside the body, especially bones
• MRI scan —a test that uses magnetic waves to make pictures of the inside of the body
• Myelogram —a specialized type of x-ray that requires dye to be inserted near the spinal cord and shows if there is pressure on the cord or the nerves
• CT scan —a type of x-ray that uses a computer to make pictures of the inside of the body

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 medicines. You may need to stop taking aspirin or other anti-inflammatory drugs for one week before surgery. You may also need to stop blood-thinning drugs, like clopidogrel (Plavix) or warfarin (Coumadin).
• 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. The doctor will insert a scope and small instruments into these incisions. The lamina will then be removed using a drill or other tools. Once the lamina is removed, the doctor can inspect the spinal cord and discs that were hidden under the lamina.

In some cases, the doctor will do an open surgery. This involves making a larger cut in the skin over the area in the back that needs attention.

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

Laparoscopic Diskectomy © 2009 Nucleus Medical Media, Inc.

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 medicine. If you felt pain in your limbs before, you may now feel numbness and tingling.

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 sock 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.
• 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 medicine recommended by your doctor. Ask your doctor before taking any over-the-counter medicine.
• Have the stitches or staples removed in two weeks.

RESOURCES:

Family Doctor
http://familydoctor.org/

National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov/

CANADIAN RESOURCES:

College of Family Physicians of Canada
http://www.cfpc.ca/

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

References:

American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org .

Herniated disc. American Association of Neurological Surgeons website. Available at: http://www.neurosurgerytoday.org/what/patient_e/herniated.asp . Updated September 2005. Accessed June 13, 2008.

Laminectomy or laminotomy. North American Spine Society website. Available at: http://www.spine.org/Pages/ConsumerHealth/SpineConditionsAndTreatments/CommonProblemsCorrectiveActions/CommonSurgicalProcedures/LaminectomyorLaminotomy.aspx . Accessed June 13, 2008.

Lindström D, Azodi O, Wladis A, Tønnesen H, 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/chronicpain/detailchronic_pain.htm#Treatment . Updated May 2008. Accessed June 13, 2008.