(Lamina Removal; Removal of the Lamina; Laminotomy)
Definition
Definition
A laminectomy is a surgery to remove a small portion of a vertebra called the lamina. Vertebrae are the bones of the spine. The lamina is a small tall like portion on the rear of the vertebra.
In some cases, only a portion of the lamina is removed from the vertebra. This procedure is known as laminotomy.
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Reasons for Procedure
Reasons for Procedure
A laminectomy is usually done to help take pressure off your spinal cord or a nerve running out from your spinal cord. It is also done to gain access to the spinal cord, bones, and discs that are below the lamina. Herniated discs, bony spurs, or other problems can cause narrowing of the canals that the nerves and spinal cord run through. This can irritate the nerve if it gets too narrow. Often, a laminectomy is done along with a disk removal to help make the canal larger and take pressure off the nerve being irritated.
When the spinal cord or other nerves get irritated, they can cause:
- Weakness
- Numbness
- Pain in an arm or leg
Physical therapy and medication will be tried first.
The surgery is done when other treatments have not worked. It is most often done to treat symptoms that keep getting worse.
Possible Complications
Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Infection
- Bleeding
- Blood clots
- Damage to nerves, resulting in pain, numbness, tingling, or paralysis
- Problems related to anesthesia
Factors that may increase the risk of complications include:
- Another medical condition, particularly heart or lung problems
- Obesity
- Increased age
- Smoking
What to Expect
What to Expect
Prior to Procedure
Your doctor may do the following:
- Physical exam
- Imaging tests used to evaluate the spine and nerves include:
In the time leading up to your surgery:
- If you are overweight, talk to your doctor about how to successfully lose weight. This will decrease the amount of stress on your back.
- Talk to you doctor about your medications. You may need to stop certain medications up to a week before your procedure.
- Arrange for a ride home and for help at home.
- Eat a light meal the night before. Avoid eating or drinking anything after midnight.
Anesthesia
Possible types of anesthesia for this operation include:
- General anesthesia —you will be asleep through the procedure
- Spinal anesthesia —numbs the area from the chest down to the legs
Description of the Procedure
If the surgery is done with minimally invasive techniques, you will only need a few small incisions. A scope and small instruments will be inserted into these incisions. In some cases, open surgery will be done. This involves making a larger cut in the skin over the area in the back.
Once the area is visible, part or all of the lamina will be removed using a drill or other tools. The affected nerves may be moved into a better location to reduce further irritation. The spinal cord and discs between the vertebra will be inspected. If needed, the disc will also be removed to reduce pressure on the spinal cord or nerves. Other issues like bone spurs will be addressed as well.
When the work is complete, the incision will be closed with stitches or staples.
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How Long Will It Take?
1-3 hours
How Much Will It Hurt?
Anesthesia will prevent pain during the procedure. You will have pain during recovery. Pain medication will help manage pain.
Average Hospital Stay
The length of stay will depend on the amount of work that was done. You may be able to go home the same day or you may need to stay in the hospital for a couple of days.
Post-procedure Care
At the Hospital
Recovery at the hospital may include:
- Walking with assistance the evening after surgery or the next day
- A back or neck brace
- Special socks or boots to help prevent blood clots
At Home
The type and extent of surgery will determine how long you will be in recovery. Activities that place stress on the back such as bending or lifting will be restricted for a few months. Your return to work will depend on the physical requirements of your job. Staying active with appropriate activity like walking is important to speed recovery. Physical therapy will be recommended to help reagin strength and flexibility.
Medications will help manage pain and swelling pain.
Call Your Doctor
Call Your Doctor
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Persistent nausea and/or vomiting
- Pain that you cannot control with the medications you’ve been given
- Cough, shortness of breath, or chest pain
- Trouble urinating or having a bowel movement
- New numbness or weakness in the hips, groin, or legs
- Joint pain, fatigue, stiffness, rash, or other new symptoms
If you think you have an emergency, call for medical help right away.
RESOURCES:
National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov
CANADIAN RESOURCES:
The College of Family Physicians of Canada http://www.cfpc.ca/ForPatients
References:
Djurasovic M, Glassman SD, et al. Contemporary management of symptomatic lumbar spinal stenosis. Orthop Clin North Am. 2010;41(2):183-191.
Herniated disc. American Association of Neurological Surgeons website. Available at:
http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Herniated%20Disc.aspx
Updated July 2014. Accessed March 24, 2015.
Laminectomy. Encyclopedia of Surgery website. Available at:
http://www.surgeryencyclopedia.com/Fi-La/Laminectomy.html
Accessed March 24, 2015.
Lindström D, Azodi O, et al. Effects of a perioperative smoking cessation intervention on postoperative complications: A randomized trial. Ann Surg. 2008;248(5):739-745.
Pain: Hope through research. National Institute of Neurological Disorders and Stroke website. Available at:
http://www.ninds.nih.gov/disorders/chronic_pain/detail_chronic_pain.htm
Updated February 23, 2015. Accessed March 24, 2015.
Last Updated: 3/24/2015