What is a lumbar laminectomy?
A lumbar laminectomy is a very common surgery where a spinal surgeon removes some bone to relieve pressure on one or more nerve roots in a patient’s lower back. Ligaments pressing on nerves and bone spurs may also be removed.
“Lumbar” refers to the lower spine. “Lamina” is part of the spinal canal’s boney roof and “-ectomy” means removal.
Who needs a lumbar laminectomy?
Spinal stenosis is a condition in older adults where the spinal canal begins to narrow. This is often caused by arthritis and does not have a cure; however, it can be treated. Lumbar spinal stenosis is a common reason for needing a lumbar laminectomy.
Spinal stenosis may require a laminectomy to repair if:
- Daily activity is hindered due to pain or decreased mobility.
- Nonsurgical treatments do not relieve pain.
- Symptoms, like weakness or numbness, are worsening.
- Bladder or bowel control is weakening.
- The patient experiences a sudden change in his/her ability to walk or move steadily.
Lumbar laminectomies may also treat conditions like herniated disks, spinal injuries or tumors. Ultimately, any condition that puts pressure on a spinal nerve and does not respond to nonsurgical treatments could be a case for a lumbar laminectomy.
How is the lumbar laminectomy procedure done?
Spinal surgery patients are given general anesthesia. For a lumbar laminectomy, patients lay on their abdomen or side. An incision is made in the lower back. A spinal surgeon will cut away the bone, bone spurs, and ligaments that are putting pressure on the affected nerves. The amount of tissue removed depends on each individual case. Additional images and details illustrating how a lumbar laminectomy is performed are available here.
Depending on the patient’s individual situation, a spinal fusion may be performed along with a lumbar laminectomy. This is another major surgery, focused on providing stabilization for the spine. Techniques for performing a spinal fusion vary but the goal is the same: use some form of implant to connect multiple vertebrae and increase stability of the spine.
How effective is a lumbar laminectomy?
When nonsurgical treatments are not relieving pain, surgery can often help patients return to health. Research shows that three months after surgery, those who underwent surgery noticed a greater improvement in their symptoms than those who did not undergo surgery. Surgery patients also experienced less long- term leg pain, were generally more active, and reported being more satisfied than those who did not pursue surgery.
A second surgery may be necessary if symptoms return years later. You could require another lumbar laminectomy if regrowth of tissue presses on your spinal cord or spinal nerve roots, spinal stenosis develops in another area, instability develops (no spinal fusion), or the original surgery did not control your symptoms.
What is the recovery time for a lumbar laminectomy?
Some patients return home the same day that they receive a lumbar laminectomy. However, most people are admitted to the hospital for one to five days.
Recovery time depends heavily on the patient’s health and the extent of the surgery. Muscles, nerves, and bone will all need time to heal after a lumbar laminectomy. It is not unusual to need several months or more to return to normal day-to-day activities.
Patients who also undergo a spinal fusion do experience a longer recovery time, as there is more to recover from in those cases.
What are the risks of a lumbar laminectomy?
The lumbar laminectomy procedure, like all surgeries, has inherent risks. The most common complications with invasive surgeries are hemorrhage, infection, and an adverse reaction to anesthesia. Other potential risks include blood clots, trouble urinating, loss of bladder or bowel control, and an unstable spine.
Since this procedure focuses on the nervous system, nerve damage is possible. Paralysis is also possible; however, it is uncommon and would be unusual for a lumbar laminectomy. The spinal cord stops around the T12 to L1 level, while this procedure tends to be performed much lower on the back.
In the event that a dural sac is breached, there may be a cerebrospinal fluid leak. This sounds very serious, but does not impact the outcome of the lumbar laminectomy. Patients usually only need to lay down for about 24 hours to give the leak time to seal.
If a patient has both a lumbar laminectomy and a spinal fusion, the risk of complications does increase, due to the extent of the surgery being greater.
How do I schedule a lumbar laminectomy?
This is a major surgery! Regardless of how uncomfortable your current situation is, you need to approach a lumbar laminectomy properly. Prior to undergoing the procedure, you need to meet with a spinal doctor to assess your current health and discuss your expectations of the surgery. Once everyone is on board with a treatment plan, then you can go forward with scheduling your surgery.
Please contact the South Texas Spinal Clinic at (210) 614-6432 to take the first steps towards fixing your spinal health issues. Our highly skilled doctors and medical support staff will do everything possible to meet your needs with compassion and understanding.