Why would you require a Laminectomy - Procedure and Risks.

Back or neck pain that interferes with normal daily activities may need surgery for treatment. Laminectomy is a type of surgery in which a surgeon removes part or all of the vertebral bone (lamina). This helps ease pressure on the spinal cord or the nerve roots that may be caused by injury, herniated disk, narrowing of the canal (spinal stenosis), or tumors. A laminectomy is considered only after other medical treatments have not worked.

Why it's done?

Bony overgrowths within the spinal canal can narrow the space available for your spinal cord and nerves. This pressure can cause pain, weakness or numbness that can radiate down your arms or legs.

Because the laminectomy restores spinal canal space but does not cure you of arthritis, it more reliably relieves radiating symptoms from compressed nerves than it does back pain from spinal joints.

Your doctor may recommend laminectomy if:

• Conservative treatment, such as medication or physical therapy, fails to improve your symptoms


• You have muscle weakness or numbness that makes standing or walking difficult


• You experience loss of bowel or bladder control

In some situations, laminectomy may be necessary as part of surgery to treat a herniated spinal disk. Your surgeon may need to remove part of the lamina to gain access to the damaged disk.

How Do I Prepare for a Laminectomy?

Tell your doctor if you:

• Take any prescription or over-the-counter drugs, vitamins, or supplements


• Are pregnant or think you may be pregnant


• Are sensitive or allergic to any medications, anesthetic agents, tape, or latex

Before the surgery, your doctor may ask you to:

• Stop taking blood thinners, such as aspirin


• Stop smoking if you’re a smoker


• Not eat or drink anything after midnight the evening before the surgery

You should arrange for someone to pick you up and take you home after the surgery. You may also need to arrange for someone to help you around the house while you heal.

What happens during a laminectomy?

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

A laminectomy may be done while you are asleep under general anesthesia. Or it may be done while you are awake under spinal anesthesia. If spinal anesthesia is used, you will have no feeling from your waist down. Newer techniques are being developed that may allow a laminectomy to be done under local anesthesia as an outpatient. Your doctor will discuss this with you in advance.

Generally, a laminectomy follows this process:

• You will be asked to remove clothing and will be given a gown to wear.


• An IV (intravenous) line may be started in your arm or hand.


• Once you are under anesthesia, a urinary drainage catheter may be inserted.


• If the surgical site is covered with extra hair, the hair may be clipped off.


• You will be positioned either on your side or belly on the operating table.


• The anesthesiologist will continuously watch your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.


• The healthcare staff will clean the skin over the surgical site with an antiseptic solution.


• The surgeon will make a cut (incision) over the selected vertebra.


• The surgeon will spread the muscles apart.


• The surgeon removes the bony arch of the posterior part of the vertebra (lamina) to ease the pressure on the nerves in the area. This may involve removing bone spurs or growths, or removing all or part of a disk.
  In some cases, spinal fusion may be done at the same time. During a spinal fusion, the surgeon will connect 2 or more bones in your spine.


• The incision will be closed with stitches or surgical staples.


• A sterile bandage or dressing will be applied.

What Are the Risks of Laminectomy?

The risks of spine surgery include:

• Damage to a spinal nerve


• Unsuccessful treatment, which can lead to pain that persists after surgery


• A return of back pain, particularly after spinal fusion


• An infection in the surgical site or vertebral bones


• A cerebrospinal fluid leak because of a tear of the dura mater, which is the membrane that surrounds the spinal cord

The general risks of surgery include:

• A blood clot in the legs, which can lead to a pulmonary embolism


• Breathing difficulties


• An infection


• Blood loss


• A heart attack


• A stroke


• A reaction to medication