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Spinal Laminectomy

Back pain that interferes with normal daily activities may require surgery for treatment. Laminectomy is a type of surgery performed at Beaumont in which a surgeon removes part or all of the vertebral bone (lamina) to relieve compression of the spinal cord or the nerve roots that may be caused by injury, herniated disc, spinal stenosis (narrowing of the canal), or tumors. A laminectomy is considered only after medical treatments have proven to be ineffective.

Other related procedures that may be used to help diagnose back problems include CT scan, X-ray, MRI, electromyogram (EMG) and myelogram.

Reasons for a laminectomy

Low back pain can range from mild, dull, annoying pain, to persistent, severe, and disabling pain. Pain in the lower back can restrict mobility and interfere with normal functioning. Laminectomy may be performed to relieve pressure on the spinal nerves, treat a disc problem or remove a tumor from the spine.

One common reason for undergoing a laminectomy is a herniated disc in the spine. A disc may be displaced or damaged because of injury or wear and tear. When the disc presses on the spinal nerves, this causes pain, and sometimes numbness or weakness. The numbness or weakness will be felt in the body part where the nerve is involved, often in the legs. The most common symptom of a herniated disc is sciatica (generally, a sharp, shooting pain along the sciatic nerve called radiculopathy, extending from the buttocks to the thigh and down the back of the leg).

If medical treatments are not satisfactory, back surgery may be an effective treatment. Some medical treatments for back pain may include, but are not limited to, the following:

  • activity modification
  • medication, such as muscle relaxants, anti-inflammatory drugs, and analgesics
  • spinal injections
  • physical rehabilitation and/or therapy
  • occupational therapy
  • weight loss (if overweight)
  • smoking cessation
  • assistive devices, such as mechanical back supports

Laminectomy is usually performed for back pain that continues after medical treatment, or when the back pain is accompanied by symptoms of nerve damage, such as numbness or weakness in the legs.

There may be other reasons for your doctor to recommend a laminectomy.

Risks of the procedure

As with any surgical procedure, complications can occur. Some possible complications may include, but are not limited to, the following:

  • bleeding
  • infection
  • blood clots in the legs or lungs
  • spinal cord injury
  • risks associated with the use of general anesthesia

Nerve or blood vessels in the area of surgery may be injured, resulting in weakness or numbness. The pain may not be relieved by the surgery or may become worse, although this is rare.

There may be other risks depending on the specific medical condition. Be sure to discuss any concerns with the doctor prior to the surgery.

During the procedure

A laminectomy usually requires a stay in a hospital. Procedures may vary depending on the patient's condition and the doctor's practices.

A laminectomy may be performed while the patient is asleep under general anesthesia. If spinal anesthesia is used, there will be no feeling from the waist down.

Generally, a laminectomy follows this process:

  1. The patient will be asked to remove clothing and will be given a gown to wear.
  2. An intravenous (IV) line may be started in the arm or hand.
  3. Once under anesthesia, a urinary drainage catheter may be inserted.
  4. If the surgical site is covered with excessive hair, the hair may be clipped off.
  5. The patient will be positioned either on the side or abdomen on the operating table.
  6. The anesthesiologist will continuously monitor heart rate, blood pressure, breathing and blood oxygen level during the surgery.
  7. The skin over the surgical site will be cleansed with an antiseptic solution.
  8. The surgeon will make an incision over the selected vertebra.
  9. The surgeon will spread the back muscles apart.
  10. The lamina (bony arch of the posterior part of the vertebra) is removed to relieve the pressure on the nerves in the area. This may involve removing bone spurs or growths, or removing all or part of a disc.
  11. In some cases, spinal fusion may be performed at the same time. During a spinal fusion, the surgeon will connect two or more bones in the back to help stabilize the spine.
  12. The incision will be closed with stitches or surgical staples.
  13. A sterile bandage or dressing will be applied.