Laminectomy is one of the most common back surgeries. During a laminectomy, a surgeon removes the rear portion of one or more spinal bones (vertebrae). Bone spurs and ligaments that are pressing on nerves may be removed at the same time. Here’s what to expect before, during, and after your laminectomy.
Laminectomy is a common but major surgery used to treat the symptoms of spinal stenosis. While the complications of this surgery are rare, there may be a few risk factors that can delay or prevent the success of the surgery.
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The lamina is a posterior arch of the vertebral bone lying between the spinous process (which juts out in the middle) and the more lateral pedicles and the transverse processes of each vertebra. The pair of laminae, along with the spinous process, make up the posterior wall of the bony spinal canal. Although the literal meaning of laminectomy is ‘excision of the lamina’, a conventional laminectomy in neurosurgery and orthopedics involves excision of the supraspinous ligament and some or all of the spinous process. Removal of these structures with an open technique requires disconnecting the many muscles of the back attached to them. A laminectomy performed as a minimal spinal surgery procedure is a tissue-preserving surgery that leaves more of the muscle intact and spares the spinal process.
Another procedure, called the laminotomy, is the removal of a mid-portion of one lamina and may be done either with a conventional open technique or in a minimalistic fashion with the use of tubular retractors and endoscopes.
The reason for lamina removal is rarely, if ever, because the lamina itself is diseased; rather, it is done to break the continuity of the rigid ring of the spinal canal to allow the soft tissues within the canal to:
1) expand (decompress)
2)change the contour of the vertebral column
3) permit access to deeper tissue inside the spinal canal
A laminectomy is also the name of a spinal operation that conventionally includes the removal of one or both lamina, as well as other posterior supporting structures of the vertebral column, including ligaments and additional bone. The actual bone removal may be carried out with a variety of surgical tools, including drills, rongeurs and lasers.
The success rate of a laminectomy depends on the specific reason for the operation, as well as proper patient selection and the surgeon’s technical ability. The first laminectomy was performed in 1887 by Victor Alexander Haden Horsley,a professor of surgery at University College London. A laminectomy can treat severe spinal stenosis by relieving pressure on the spinal cord or nerve roots, provide access to a tumor or other mass lying in or around the spinal cord, or help in tailoring the contour of the vertebral column to correct a spinal deformity such as kyphosis. A common type of laminectomy is performed to permit the removal or reshaping of a spinal disc as part of a lumbar discectomy. This is a treatment for a herniated, bulging, or degenerated disc.
The recovery period after a laminectomy depends on the specific operative technique, with minimally invasive procedures having significantly shorter recovery periods than open surgery. Removal of substantial amounts of bone and tissue may require additional procedures such as spinal fusion to stabilize the spine and generally require a much longer recovery period than a simple laminectomy.
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A laminectomy usually takes one to three hours and a hospital stay of 1 to 4 days is typically required following a lumbar laminectomy surgery.
The success rate of a lumbar laminectomy to alleviate leg pain from spinal stenosis is generally favorable. Research suggests:
Although the outcome of lumbar laminectomy is usually good, about 10% to 15% of patients may subsequently require a repeat surgery due to post-operative complications.
Improper diagnosis, physical deconditioning before and/or after surgery, and smoking are a few examples of causes for surgical failure. Choosing the right candidate who may benefit from this surgery can help prevent future complications.
A well-known complication of lumbar laminectomy is excessive shear displacement in the intervertebral joint, leading to postoperative spondylolysis or spondylolisthesis. In most cases, the degree of bone, ligament or facet joint removal will not significantly affect the strength of the spine. However, depending on the amount of tissue removal and whether the spine has been weakened by arthritis, degenerative changes or previous surgery, the strength of the spine may be compromised.
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10 common questions about Is a Laminectomy a Major Surgery
How long does a laminectomy surgery take?: one to three hours
Your surgeon may also perform a foraminotomy to widen the area where the nerve roots go through the spine. A laminectomy usually takes one to three hours.
What is the success rate of a laminectomy?: 80 percent
Laminectomy enlarges your spinal canal to relieve pressure on the spinal cord or nerves, and has about an 80 percent success rate at improving walking abilities.
Is a laminectomy an outpatient surgery?: Discectomy and laminectomy are common surgical procedures for degenerative lumbar spine conditions. … Compared with postoperative in-hospital stays, outpatient discectomy is safe,3,5,6 favoured by the most patients,7 and associated with decreased complications.
Does laminectomy weaken the spine?: Pain in the spine can restrict your ability to move and function. Laminectomy may be done to ease pressure on the spinal nerves, treat a disk problem, or remove a tumor from the spine. One common reason for having a laminectomy is a herniated disk in the spine. … The most common symptom of a herniated disk is sciatica.
How soon can you walk after a laminectomy?: After a minor (decompressive) laminectomy, you can usually able do desk work and light housekeeping within a few days to a few weeks. If you also had spinal fusion, your recovery time will likely be longer, 2-4 months. You may not be able to lift and bend for 2-3 months.
Does the bone grow back after a laminectomy?: Years after decompression (lumbar laminectomy), lumbar stenosis can come back (the bone can grow back) at the same level, or a new level can become stenotic and cause back pain or leg pain. … Failed Back Surgery Syndrome (FBSS): What It Is and How to Avoid Pain after Surgery.
Can a laminectomy be done twice?: In essence, a revision laminectomy is the same procedure as a standard laminectomy. It is simply being performed for a second time. … Because a laminectomy can only treat the symptoms of this condition, rather than the cause, regrowth is not only possible, but likely in many circumstances.
How dangerous is a laminectomy?: A few potential complications of open lumbar laminectomy are: Neural tissue damage. Injury to the spinal cord\’s dura, cauda equina syndrome, nerve roots, and the formation of scar tissue may occur causing neural tissue damage in the lumbar spine.
Is it normal to have leg pain after laminectomy?: Sometimes this is a temporary condition as the nerve root or roots take time to heal. This can take days to weeks. If the pain is still there after 3 months, it is unlikely to improve on its own. Below are a few reason why leg pain may persist after surgery
How long after a laminectomy can I fly?: When can I travel by plane after surgery? Although you can travel immediately after surgery, we advise, whenever possible, to avoid short flights travelling for 6 weeks and long-haul flights for 12 weeks after surgery.