A laminectomy is a surgical procedure that can effectively relieve the compression of the spinal nerves and resultant pain caused by spinal stenosis. Spinal stenosis is a condition that involves a narrowing of one or more areas of the spine, placing excessive pressure on the spinal nerves in the region. It often produces pain, cramping and numbness in the neck, shoulders, arms, lower back or legs, depending on where on the spine the problem occurs. This condition can develop as a result of injury or deterioration to the discs, joints or bones within the spinal canal.
In a laminectomy procedure, a small section of bone that covers the back of the spinal cord, called the lamina, is removed. The removal of this portion of the bone and any nearby bone spurs relieves the pressure on the spinal cord. This type of surgery is typically performed through the back. The location of the approach through the back will vary depending on what level of the spine it is that the nerve roots have been affected. It most commonly occurs in either the cervical, or neck, region or the lumbar, or lower back, area.
The spine is the long column of vertebral bones and discs that protect the spinal cord and the many nerves that branch off from it and provide function and movement to nearly every area of the body. The cervical and lumbar spine are most commonly affected by injury and disease because of their frequent use and pressure put on them from sitting, standing, sleeping and working. Each of these areas of the spine is composed of several vertebrae and a disc in between each set, which cushions the vertebrae and prevents them from rubbing against each other.
While many cases of spinal stenosis can be successfully treated through conservative methods such as physical therapy, nonsteroidal anti-inflammatory drugs, rest and a back brace, some patients do not respond to these measures. If the symptoms of spinal stenosis become progressively worse, a laminectomy may become necessary. It can provide relief from the pain, numbness or weakness many patients experience in one or both arms or legs.
A laminectomy of the spine is performed through the affected area of the back while the patient is under general anesthesia. Once the skin at the treatment site has been cleaned with an antiseptic, the surgeon makes an incision and carefully retracts the muscles and ligaments to obtain access to the spine. An imaging device such as an X-ray is typically used during the surgery to view the structures of the vertebrae and pinpoint the problem area.
Depending on the extent of the damage, the lamina may be removed in portions or in its entirety on both sides of the spine. The surgeon will then assess the region, removing any calcified cartilage as well as the spinous process, which are sharp protrusions at the back of each vertebrae, if necessary. By removing the lamina, bone spurs and other debris, the compression of the spinal cord and spinal nerves is alleviated and symptoms will improve. Once this is completed, the muscles and other tissue of the back are repositioned and the incision is sutured closed. The laminectomy procedure typically lasts between one and three hours.
Recovery from Laminectomy
A laminectomy should relieve much or all of the pain and numbness in the arms or legs that stenosis sufferers experience. After the procedure, you will most likely need to remain in the hospital for one to three nights. Soon afterward, most patients begin a physical therapy regimen to build up their muscle strength and flexibility. There will be restrictions from activities that require reaching, bending and lifting for several weeks following the procedure. Generally, most people can return to work in approximately three months.
Risks of Laminectomy
Laminectomy is a spinal surgery procedure and as such, it carries some risk. The complications that may be associated with this procedure include infection, blood clot formation, nerve damage and an adverse reaction to anesthesia.