What is a Laminectomy?
A laminectomy is a surgical procedure that relieves spinal nerve compression caused by spinal stenosis or a herniated disc. Spinal stenosis occurs whe one or more areas of the spinal canal narrow. A herniated disc occurs when a disc, the gelatinous tissue between two vertebrae, protrudes outside of the spine.
Spinal Stenosis Causes
Both spinal stenosis and disc herniation cause excessive pressure on adjacent spinal nerves. This results in pain, numbness, cramping, tingling, or weakness in the neck, shoulders, arms, lower back or legs. This is dependent on where on the problem in the spine occurs. Both conditions may be due to aging, injury, or arthritic deterioration.
Herniated Disc Treatment
While most cases of spinal stenosis or disc herniation can be treated through one or more conservative methods, such as rest, physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), or the support of a back brace, these treatments are not always sufficient. If the symptoms become progressively worse, a laminectomy may be necessary. This surgical procedure is minimally invasive and can provide effective relief from the pain, weakness, or numbness that many patients experience.
During a laminectomy procedure, the lamina, a small section of bone that covers the back of the spinal cord, is removed. By removing this portion of the bone and any nearby bone spurs, pressure on the spinal cord is relieved. This procedure is typically performed through the back. The location of the incision itself will vary depending on which nerve roots have been affected. Spinal damage most commonly occurs in either the cervical (neck) or lumbar (lower) regions. These areas are injured more often due to pressure put on them by everyday activities such as standing, sitting, walking and bending.
An X-ray, is typically used during surgery to ensure that the structures of the vertebrae can be precisely visualized and the problem area can be pinpointed.
The lamina may be removed in portions or in its entirety, depending on the extent of the damage. Once the region is assessed, the surgeon will remove any necessary calcified cartilage or spinous processes, the sharp protrusions at the back of each vertebra. After the lamina, bone spurs and other debris are removed, the compression of the spinal cord and spinal nerves is relieved and symptoms will begin to improve. The laminectomy surgery typically lasts between 1 and 3 hours.
A laminectomy usually relieves most of the pain and numbness that patients suffer from as a result of spinal stenosis or disc herniation. After the surgery, patients usually remain in the hospital for several nights. A physical therapy regimen is begun soon afterward in order to build up muscle flexibility and strength. For the weeks following the procedure, activities such as reaching, lifting and bending will be restricted. Most people will return to work in about 3 months.
As the healing process begins, a physical therapist will work with the patient to help increase their range of motion and mobility. Some exercises may include:
- Lumbar exercises
- Posture conditioning
- Leg extensions
- Hip and core exercises
Since a laminectomy is a spinal surgery procedure, it carries some risk with it. Some complications may include postsurgical infection, breathing problems, blood clot formation, nerve damage or adverse reaction to medication or anesthesia. Despite any risks, laminectomy procedures are mostly successful and uneventful.