Surgical Procedures
LUMBAR LAMINECTOMY 


1. WHAT IS A LAMINECTOMY?

A laminectomy is, strictly speaking, an operation to expose the spine where the nerves are. As the name implies, laminectomy means removing the lamina (the bony covering to the nerves in the back of the spinal column). It is also a treatment because un-roofing the nerves often removes the pressure on these nerves.

2. WHAT CONDITIONS DOES LAMINECTOMY TREAT?

Laminectomy is usually used to treat a condition called spinal stenosis. Spinal stenosis is a condition in which there is nerve impingement due to bone spurs, calcium deposits, or thickened ligaments. In the process of the laminectomy, these offending structures are removed, therefore "freeing up" the nerves. A laminectomy is also sometimes used to decompress the nerves when they are compressed by other conditions, such a tumor, large herniated disk, or bone fragments from fracture.

3. WHAT IS BELIEVED TO BE THE CAUSE OF SPINAL STENOSIS?

The exact cause is unclear but appears to be related to repeated stresses over the years. If the spine is subjected to repeated stress, the bones respond by enlarging. There are some soft tissues which also increase in size. As these structures increase in size, there is less room for the nerves to pass through their openings resulting in spinal stenosis.
Spinal stenosis is a common problem in people over 50 years old. It is most common between the third and fourth, and the fourth and fifth, lumbar vertebrae.
The pressure on these nerves often will increase when you are standing or walking, causing weakness or an increase in your back pain and leg pain. The leg symptoms are quite varied, ranging from mild aching to severe fatigue. Leg pain, buttock pain, pins and needles, numbness, and multiple combinations of these symptoms are also common.
The goal of a laminectomy is to enlarge the openings for your nerves by removing the excess bone and soft tissue. The goal is to remove enough of these offending structures to decompress the nerves, but not so much that the spine is rendered unstable.

4. CAN YOU GIVE MORE DETAILS ABOUT THE OPERATION ?

The operation takes approximately 2 hours to perform, and then you will be in the recovery room for about 2 hours. We will have you get out of bed and walk on the first day after surgery. Early walking can help to avoid many complications. We try to keep you as comfortable as possible with strong pain medications, but there is no way to get you pain free. You usually are in the hospital from two to four days. Our main focus will be to get you moving and independent as soon as possible.

5. WHAT ARE SOME OF THE PROBLEMS THAT I CAN EXPECT AFTER SURGERY WHILE IN THE HOSPITAL?

A common problem is that your stomach and bladder may be temporarily not functioning due to the anesthesia and immobility. This may require use of a urine catheter in your bladder to keep the bladder empty. If your stomach does not work, you may not be able to eat or drink for a few days. You are allowed to go home when you are off pain shots, when you are able to get out of bed, and when your stomach and bladder are working.