A laminectomy is a surgery on your spine to remove the lamina, the “bony arch” that supports the back of your spinal cord. If you’re facing severe back and neck pain or a herniated disk, it may be a good treatment option to decrease your symptoms if other medical treatments haven’t worked.
Overview Overview What Is a Laminectomy? Pressure in the spinal canal (and resulting pain) is often caused by bony overgrowths in the space, which can be attributed to aging, genetics, and injuries. A laminectomy is a surgery to remove part of the vertebral bone (called the lamina) to relieve this pressure on the spinal cord and nerves in the area by making more room along your spinal cord.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bcc321c5-57d8-4cf8-8aa7-fc8cb9a2dea4 “In basic terms, it’s creating space in the spinal canal for nerves that are being pinched. When there’s tightness, the nerves get irritated, and that can cause symptoms like pain, numbness, tingling, and weakness from being compressed,” says Payam Farjoodi, MD , a board-certified orthopedic spine surgeon who treats patients with both common and complex spinal disorders and deformities in Orange County, California. “The laminectomy alleviates those symptoms by cutting away some of the bone,” Dr. Farjoodi says. It’s a common procedure, but it is considered a major surgery because of the proximity to delicate structures of the spine.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b67c9373-45c6-44f2-b2c8-8b8fbdd58ea5
Why Is Laminectomy Done? Why It’s Done If you’re grappling with lower back or neck pain that can be severe and disabling, or restrict your ability to move and function, your doctor may recommend a laminectomy when more conservative treatments — like medication, physical therapy, or injections — have failed to ease pain. Candidates for a laminectomy are often patients with the following conditions:e60dc2a1-f33c-4a05-9b50-8e3e8e597629a7cc5a17-96be-4df2-abcd-215e21cd936c Arthritis Bone fractures Bone spurs Degenerative back conditions Herniated disk Spinal stenosis , which is a narrowing of the spinal column Spinal tumors or abscesses Laminectomy can also be an option to treat chronic symptoms, such as: Severe neck, shoulder or back pain causing persistent pain Pain and weakness or numbness in your arms and legs from spinal cord or nerve damage Weakness or heaviness in your buttocks or legs Bowel or bladder problems from pressure in the cervical or lumbar spine You and your doctor can decide whether you need to have surgery for these symptoms, especially if they’re interfering with your daily life or your job. Farjoodi says the need for a laminectomy usually comes back to four key factors: genetics, wear and tear through repetitive movements, back and neck injuries, and age. With respect to the last one, he adds: “As we age, inevitably, things begin to wear out.” Before laminectomy, your healthcare provider might suggest these treatments and lifestyle changes:e60dc2a1-f33c-4a05-9b50-8e3e8e59762950dd157e-2d3f-4750-a78d-5cb7bc2c2d4a Adjustment to your physical activity Medication, including muscle relaxants, anti-inflammatory medicines, and pain relievers Spinal injections Physical rehabilitation, physical therapy, or both Occupational therapy Weight loss (if you’re overweight) Smoking cessation Assistive devices, such as mechanical back supports
How Is a Laminectomy Performed? How It’s Performed To perform a laminectomy, your surgeon will:e60dc2a1-f33c-4a05-9b50-8e3e8e59762953be9ef2-2442-4796-87df-9870cf0a9bf2 Make an incision in your back or neck, depending on where you’re feeling pain or pressure Separate or move your skin, ligaments, and muscles to the side to access your spine Use a surgical microscope to get a close look at the bone or area of your affected spine Remove all or part of your lamina with small instruments, as well as any disk fragments, bone spurs, or affected soft tissue (they’ll remove the smallest amounts of your lamina as possible) If necessary, perform a foraminotomy (which involves widening a spinal opening for nerve roots) or a spinal fusion procedure (which is to stabilize the bones in your spine). If a laminectomy is performed as part of a surgery for a herniated disk, your surgeon will remove the herniated portion of the disk and any pieces that have broken loose. This is called a diskectomy. Move your muscles, ligaments, and skin back in place Sew or stitch your skin closed around the incision site In some cases, the surgery is minimally invasive, meaning your surgeon will make a tiny incision and use a special surgical microscope to gain access to your spine rather than a “traditional open approach,” Farjoodi says.
How Do I Prepare for a Laminectomy? How to Prepare Before your surgeon does the laminectomy, he or she will X-ray your spine. They may also conduct an MRI or CT myelogram to confirm if you have spinal stenosis and its exact location. You’ll also need to tell your doctor what medicines you’re taking, including prescribed drugs, supplements or herbs.e60dc2a1-f33c-4a05-9b50-8e3e8e597629589bf995-2266-4bcf-8ac6-85a396391a2e Laminectomy is not an emergency procedure. Typically it is scheduled from as short as two weeks to several months ahead of time. Farjoodi prefers to schedule the procedure several months out, so that patients can spend at least two to six weeks preparing to set themselves up for better recovery. Farjoodi often gives patients the following recommendations: Do physical therapy and exercise. You will have a better chance of bouncing back post-op if you maintain strong core muscles .e60dc2a1-f33c-4a05-9b50-8e3e8e597629ca7615e4-04fd-463a-807a-12a3d28684ed Farjoodi suggests exercise that’s safe for your abilities but keeps your body strong and in movement. He connects patients with physical therapists for about four to six weeks of exercise when a patient is preparing for a laminectomy, and then assesses their progress. Quit smoking. If you are a smoker, you should stop before laminectomy, as smoking slows down wound healing, which can lead to complications after surgery.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e053dfcc-801c-4820-bc29-5c5f170f95f2 Farjoodi encourages his patients to stop smoking as far in advance as possible. Monitor (and manage) blood sugar levels if you’re diabetic. Farjoodi will take extra time with diabetic patients to optimize their glucose levels, through medication and eating a diabetes-friendly diet limiting sugar and processed foods. “If we have elevated blood sugars going into surgery, we run the risk of poor healing and increased rate of infection,” he says. Try to lose weight if your body mass index falls in the overweight or obese categories. Overweight patients put a lot of stress on their discs and accelerate the degeneration of their lamina, causing wear and tear. Farjoodi also encourages patients to try to lose weight — at a healthy one to two pounds per week — to ease symptoms pre- and post-op. “Practically speaking, I like to see any weight loss. If we lose some weight, even a little bit, that tends to have a pretty profound effect on back pain,” Farjoodi says. If you have other chronic diseases, connect with providers managing those conditions for specific recommendations. If you have diabetes , heart disease , or other medical problems, your surgeon will ask you to see your regular provider to ensure these problems are under control. Often, they’ll have to receive clearance from your care team before booking the surgery.e60dc2a1-f33c-4a05-9b50-8e3e8e597629589bf995-2266-4bcf-8ac6-85a396391a2e Tell your healthcare provider if you have any allergies. This includes any sensitivities to or allergies to any medicines, latex, tape, and anesthesia medicines (local and general).e60dc2a1-f33c-4a05-9b50-8e3e8e597629ca7615e4-04fd-463a-807a-12a3d28684ed And in the days before surgery, remember to: Prepare for when you leave the hospital and return home, so you have the liquids, nourishing meals, comfortable bedding, and everything you’ll need to rest and recover comfortably on hand.e60dc2a1-f33c-4a05-9b50-8e3e8e597629589bf995-2266-4bcf-8ac6-85a396391a2e Stop taking blood thinners in the week before surgery. Some of these drugs include aspirin and Plavix . Also stop ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn) , which are anti-inflammatory medicines that can affect bleeding. If you are taking warfarin (Coumadin), dabigatran (Pradaxa) , apixaban (Eliquis) , rivaroxaban (Xarelto) , or clopidogrel (Plavix) , talk with your surgeon and your prescribing doctor before stopping or changing how you take these drugs.e60dc2a1-f33c-4a05-9b50-8e3e8e597629589bf995-2266-4bcf-8ac6-85a396391a2e Keep your surgeon updated on any health changes by letting them know right away if you get a cold , flu , COVID-19 , fever, herpes breakout, or other illnesses you may develop.e60dc2a1-f33c-4a05-9b50-8e3e8e597629589bf995-2266-4bcf-8ac6-85a396391a2e In some cases, your surgery may be postponed altogether to make sure you’re in better health before undergoing surgery. This is to ensure you have the best shot at a smooth recovery, so your body can focus solely on healing instead of fighting an infection.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c3b81b84-e7cb-4a5d-aa67-edb687ac5c32 Arrange for someone to pick you up post-op , take you home safely, and help you for a few days with household activities and driving.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ca7615e4-04fd-463a-807a-12a3d28684ed And on the day of the surgery, you will likely: Be asked not to drink or eat anything for 6 to 12 hours before the procedure.e60dc2a1-f33c-4a05-9b50-8e3e8e597629589bf995-2266-4bcf-8ac6-85a396391a2e
What Should I Expect During a Laminectomy? What to Expect A laminectomy is typically an outpatient procedure, meaning most patients go home the same day of the surgery, according to Farjoodi. It usually takes about an hour but can be up to three hours, depending on the complexity of the surgery. Note that you’ll likely spend another three hours at the hospital after the procedure before being allowed to go home, so that your doctor can monitor your vital signs post-op and make sure you’re stable. “This is a straightforward procedure that tends to have minimal risk, and requires minimal recovery time,” Farjoodi says. On the day of your surgery, an anesthesiologist will give you general anesthesia so you’ll be asleep for the entire procedure and won’t feel any pain. You’ll lie facedown on special pads to protect the front of your body while your surgeon works on your spine.
What Are the Potential Risks Associated With a Laminectomy? Risks Farjoodi says that while the risks linked to laminectomy tend to be low, with any surgical procedure complications can occur. Some general risks include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629fa04da06-292b-4b2f-9d86-8f71ba6699bd Bleeding Infection Blood clots in the legs or lungs Spinal cord or nerve root injury Risks linked to the use of general anesthesia The need for more surgery, if anything unexpected, such as leakage of spinal fluid, occurs Injury to nerve or blood vessels in the area of surgery, which is rare, but may cause numbness or weakness
What Type of Care Is Needed Following Laminectomy? Follow-Up Care Immediately After the Procedure After the procedure, which should be between one and three hours, you’ll be taken to a recovery room for observation after the surgery. Doctors will monitor your blood pressure, pulse and breathing. Once you’re given clearance with all signs stable, you may be discharged. Your doctor will encourage you to get up and walk around, if you’re able to, when the anesthesia wears off. In some cases, you may need to stay in the hospital for one or more days.e60dc2a1-f33c-4a05-9b50-8e3e8e59762999e08364-df27-4034-b2f5-ee64d04273bf In the First Month After the Procedure At home, Farjoodi instructs patients to limit bending, lifting, and twisting movements for the first six weeks after the surgery. “That’s to help the muscles and wound heal,” he says. He also recommends a course of gentle physical therapy two weeks after surgery to build up a strong core to prevent further issues down the road. Also following the procedure, be sure to keep the surgical incision area clean and dry. Your doctor will provide you with specific instructions for bathing. Surgical staples or stitches are removed during a follow-up office visit.e60dc2a1-f33c-4a05-9b50-8e3e8e59762999e08364-df27-4034-b2f5-ee64d04273bf Your doctor will also prescribe you medication for pain relief. Take a pain reliever for soreness as recommended by your healthcare provider.
What Are the Possible Complications and Side Effects of a Laminectomy? Complications Potential complications from a laminectomy include general risks such as bleeding, infection, blood clotting, and spinal cord or nerve injury.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297cd30cdc-b020-4566-9183-6fe91e5b40bf A meta-analysis published in 2022 pored over the 5-year and 10-year post-op outcomes of more than 83,400 patients and found potential side effects, such as: Lower back pain and leg pain, although in some of the studies reviewed, patients saw a “significant improvement in pain from baseline” Disability, including difficulty walking, with one study finding that that 62.2 percent of patients were not able to walk more than 100 meters without pain pre-op, and that decreased to 8.1 percent post-op Potential re-operation
What’s Next After a laminectomy, patients often report improvement in their symptoms, especially a decrease in pain in their back, neck, and down the leg or arm. The key is to maintain good health to avoid a second procedure, which may be needed because of stress on the spine from weight gain, more wear and tear, or age-related spinal degeneration, Farjoodi says. “Anytime you have a spine issue requiring surgery, you want to stay ahead of the problem and minimize the chances of this returning,” Farjoodi says. Keep a healthy BMI , include physical activity in your daily routine, and report any symptoms of arthritis to your doctor, he says.
The Takeaway A laminectomy is performed to relieve pressure on the spinal cord and surrounding area, which typically shows up as pain in the back, neck, or down the legs or arms. If less-invasive treatment options (like medications, physical therapy, and others) don’t help symptoms, your doctor may recommend laminectomy. It’s considered a low-risk procedure, and often patients go home the same day.
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