As we age, the vertebrae that line the spine can naturally develop bony protrusions and growths that can compress the spinal cord. Compression of the spinal cord can lead to weakness and difficulty moving the hands, legs, and feet.
The most affected region of the spine is the lamina, the bony roofing that sits on top of the spinal cord. During a laminectomy, a spinal surgeon removes the portion of the affected lamina and creates more room for the spinal cord. Laminectomy is one of the most common spinal surgeries.
Learn more about the laminectomy procedure and what to expect after surgery.
What Is a Laminectomy?
Laminectomy is a spinal surgery in which the surgeon clears away the lamina—or bony roofing—that sits above the spinal cord. Laminectomy is performed when the bones that form the spine—called vertebrae—degenerate and cause compression against the spinal cord. Vertebral compression can result in:
Weakness Altered sensation Difficulty moving the arms and legs (known as myelopathy)
Removing the lamina allows the surgeon to create more room for the spinal cord and reduces compression against the vertebrae.
Laminectomy is considered a major surgery.
Types of Laminectomy Techniques
There have been many recent advances in laminectomy surgical techniques, including minimally invasive approaches that use small incisions.
Minimally invasive laminectomy generally requires less pain medication after the procedure. Work with your surgeon to outline their preferred techniques for your laminectomy and understand the options for your recovery.
Open Laminectomy
During an open laminectomy, a surgeon will make an incision in your back and then carefully cut through the spinal muscles to reach the lamina.
Once the surgeon identifies the lamina, specialized instruments are used to resect—or remove—the lamina and create room around the spinal cord.
After the lamina is resected, the surgeon removes the instruments and closes the incision.
Minimally Invasive Laminectomy
Most recently, minimally invasive surgical techniques that use small incisions have been adapted for laminectomy procedures.
In a minimally invasive laminectomy, the surgeon uses a specialized instrument called a tubular retractor—or an endoscope—that is placed through a small incision measuring approximately 2–3 centimeters using X-ray guidance.
Once the surgeon reaches the appropriate location on the spine, they can begin to resect parts of the lamina through the endoscope. After the lamina is resected, the surgeon removes the endoscope and closes the small incision.
Contraindications to Laminectomy
Laminectomy is a form of major surgery, so there may be specific conditions preventing you from having the procedure. These include:
Prior spinal surgeries or implants that affect the spinal cord Recent trauma or damage to the brain Major medical conditions, like a major heart attack or stroke
Potential Risks of Laminectomy
A laminectomy is performed near the sensitive and important spinal cord. Since the spinal cord is a key structure of the central nervous system and controls movement and sensation for the body, the potential risks from laminectomy can include damage to the nerves in the spinal cord resulting in loss of sensation, weakness, or even paralysis.
After laminectomy, it is important to keep the surgical site clean, so it does not become infected. Additionally, bleeding can occur during and after laminectomy surgery which your surgeon and anesthesiologist will closely monitor.
Minimally invasive techniques can reduce the risks of both bleeding and infection after surgery.
Laminectomy Recovery
As far as major surgeries go, a laminectomy can have a relatively quick recovery. After a minimally invasive laminectomy, you may go home the same day after your procedure. If the procedure is more complex, your surgeon may want to monitor you in the hospital for two to three days.
Once you return home, you will likely need to take it slow, but you can dress, eat, bathe, and walk around normally. You may need to limit lifting heavy objects, climbing stairs, or performing other physical activity until a few weeks after your operation to ensure you can heal properly.
You can plan to start physical therapy two to three weeks after your procedure once your surgeon feels it is appropriate.
Summary
A laminectomy is one of the more common spinal surgeries and it is used to treat spinal cord compression. If you have been diagnosed with myelopathy or spinal cord compression, you may consider working with a spinal surgeon to evaluate if you are a good candidate for laminectomy.
Recent advances have led to new minimally invasive techniques that can provide safer and more effective outcomes.
