Laminectomy
What is a laminectomy?
A laminectomy is a surgical procedure in which a surgeon removes part or all of the spinal bone (lamina) to relieve pressure on the spinal cord or nerve roots that may be caused by injury, herniated disc, narrowing of the canal (spinal stenosis) or tumours.
The specific details of the laminectomy procedure may vary depending on the patient’s condition and the surgeon’s approach. The surgeon may also perform additional procedures, such as a discectomy, foraminotomy or spinal fusion, depending on the patient’s needs.
The success rate of laminectomy is generally high, averaging over 90%.
When is a laminectomy recommended?
A lumbar laminectomy is advised in the following cases:
- Spinal stenosis: narrowing of the spinal canal causing pressure on the spinal cord or nerves.
- Herniated disc: a condition in which the soft tissue inside a disc in the spine pushes out through a crack on the outside of the disc.
- Sciatica: a condition that causes pain, numbness or weakness in the lower back, buttocks and legs due to pressure on the sciatic nerve.
- Osteoarthritis: a degenerative joint disease that causes the cartilage between joints to wear away, resulting in pain and stiffness.
- Ankylosing spondylitis: a type of arthritis that affects the spine and causes inflammation and stiffness.
- Posterior tumours: tumours that grow on the back of the spine and can cause pressure on the spinal cord or nerves.
The laminectomy procedure is often recommended when other medical treatments have not worked and the patient experiences back or neck pain that continues after medical treatment or symptoms of nerve damage, such as numbness or weakness in the arms or legs.
The procedure can relieve pressure on spinal nerves or the spinal cord, and may be performed in conjunction with a discectomy, foraminotomy or spinal fusion.
How is a microdiscectomy performed?
It is a surgical procedure that usually lasts between 1 and 3 hours. The patient is under general anaesthesia and feels no pain.
The procedure is performed to relieve pressure on the spinal nerves or spinal cord. During the surgery, the lamina, which is a part of the bone that makes up a vertebra in the spine, is removed. Laminectomy is also done to remove bone spurs or a herniated disc (slipped disc) in the spine.
In the procedure, the damaged bones and discs are removed, and more space is made available for the spinal nerves and spine. The surgery usually lasts between 1 and 3 hours and is performed under general anaesthesia.
What are the risks of laminectomy?
Laminectomy surgery is a safe and effective surgery, but like any surgical procedure, there are associated risks and complications.
The main risks are the usual risks of spinal surgery:
- Bleeding: Bleeding is a common risk in any surgery, but can be minimised by good surgical technique and the use of medications that reduce blood clotting.
- Infection: Infection is a risk in any surgery, but can be minimised by good surgical technique, use of prophylactic antibiotics and good hygiene before and after surgery.
- Nerve injury: Nerve injury is a risk in any spine surgery, but can be minimised by good surgical technique and, depending on the complexity of the case, the use of intraoperative neurophysiological monitoring.
- Residual pain: Residual pain is a common risk after surgery, but can be minimised by good surgical technique and the use of pain medication.
What is the postoperative period after laminectomy?
The laminectomy patient may need to stay in the hospital for 1 or 2 days after surgery. After surgery, the patient returns home with autonomy for basic activities of daily living, although for the first few weeks he or she should avoid exercise and strenuous activities.
Once at home, for the first few days, the surgical wound will need to be dressed daily and the patient will be monitored by the surgeon.
In general, a laminectomy is the kind of surgery that usually has a great impact on a person’s quality of life.