What is a Laminectomy

Laminectomy is a common procedure in the surgical treatment of routine spine conditions. The removal of a small amount of bone bordering the spinal cord can relieve pain and allow access to other areas of the spine. Laminectomy is less invasive than many other forms of spine surgery, while still being an effective form of treatment. However, it still requires significant downtime and risks, which some patients may wish to avoid.
 
Procedure & Uses

The vertebrae consist of a hard bony body and a central canal through which the spinal cord runs. The central canal is bordered by the body on one side and several smaller structures, including the lamina, on the other side. The lamina are thin and relatively delicate. When surgeons need to relieve pressure on the spinal cord, or need greater access to the discs, a laminectomy may be indicated. During the operation:

• The patient is put under general anesthesia, so they will not feel pain during the procedure
  
• The physician makes an incision in the skin above the vertebrae
  
• The skin, ligaments, and muscle are peeled away from the spine
  
• The physician carefully removes an appropriate amount of laminal bone, on one or both sides
  
• If necessary, the surgeon can perform other procedures, such as the removal of bone spurs or herniated disc material
  
• The wound is stitched and the patient is sent to recovery
  

The procedure can be performed on any part of the spine - lumbar, thoracic, or cervical. There are some differences in size and structure between the three sections of the spine; the cervical vertebrae are the smallest and most delicate, while the lumbar vertebrae are larger and thicker. For this reason, operating on the cervical spine is a more delicate procedure. However, the majority of laminectomies are performed on the lumbar spine.

Laminectomy may be used to treat several conditions. It is most often used to treat spinal stenosis (compression of the spinal cord); the removal of a small amount of the lamina can relieve pressure on the spinal cord. It is also sometimes used during the treatment of herniated discs, bulging discs, and degenerative disc disease, where the lamina is removed to allow access to the disc, which is then removed in part or in whole.

Alternatives

Depending on how much bone is removed, laminectomy may be less invasive than other forms of open back surgery. It is less likely to require spinal fusion or the addition of metal rods. For the most minor forms, patients may recover relatively quickly. However, the procedure still requires hospitalization and an overnight stay in the hospital, and the muscles and ligaments take time to heal. If other spine procedures are performed concurrently, the recovery time and hospital stay may be even longer. 

Like all surgery, laminectomy is not without risks. The most common side effects of open back surgery include:

• Infection of the surgical incision
  
• Ongoing pain, or failure to treat the issue
  
• Excessive bleeding at the surgical wound
  
• Clotting, which can occur as a result of inactivity after surgery
  
• Scarring, which may be more or less visible depending on the extent of the procedure and the patient's own healing process
  

These risks may be reduced, though not eliminated, by communicating with your physician about pre-existing conditions, practicing good after-surgery care, and choosing minimally invasive procedures when possible. Like other forms of spinal surgery, laminectomy is almost always effective at relieving symptoms, and the majority of patients report satisfaction with their procedure.

Minimally invasive procedures that utilize endoscopic techniques may reduce the need for laminectomy. To learn more, please call the Datta Endoscopic Back Surgery and Pain Center at 212-430-0312.