Patient education: Laminectomy (The Basics)

What is laminectomy? — 

To understand what a laminectomy is, it's helpful to first learn a little about the back and spine.

The back is made up of (figure 1):

●Vertebrae – These are the bones of the spine. Each has a hole in the center. The vertebrae are stacked on top of each other, and the holes form a hollow tube called the "spinal canal." The spinal cord passes through this tube and is protected by the vertebrae.

●Discs – Rubbery discs sit in between each of the vertebrae. They add cushion and allow movement.

●Spinal cord and nerves – The spinal cord is the bundle of nerves that connects the brain to the rest of the body. It runs through the vertebrae. Nerves branch from the spinal cord and pass in between the vertebrae. From there, they connect to the arms, legs, and organs. This is why a pinched nerve in the neck can cause arm pain, and a pinched nerve in the back can cause leg pain or bladder problems.

●Muscles, tendons, and ligaments – These support the vertebrae. They are used to move the head and neck, stand upright, and bend and flex the body. They are also called the "soft tissues" of the neck and back.

Each of the vertebrae has a "lamina." This is the part that forms the roof of the spinal canal (figure 2). It helps protect the spinal cord and nerves. Sometimes, the spinal canal can become too narrow. This is called "spinal stenosis," and can be caused by different things, including disc problems, bone spurs, or tumors. It can cause the spinal cord or nerves to get pinched, which can lead to symptoms like pain, tingling, numbness, and weakness.

Laminectomy is surgery to remove the lamina. This creates more space and helps relieve pressure. This surgery can be done in 2 ways:

●Open surgery – The doctor makes a cut ("incision") in the skin over the vertebra. This lets them see directly inside the body to do the surgery.

●Minimally invasive surgery – The doctor makes smaller incisions in the skin and works through a tube. They insert a camera and small tools through the tube to do the surgery. This is only an option in certain situations.

Usually, surgery for spinal stenosis is done after a person has tried other treatments first. Talk to your doctor about whether laminectomy is an option for you.

How do I prepare for laminectomy? — 

The doctor or nurse will tell you if you need to do anything special to prepare.

Before the procedure, your doctor will do an exam. They might also send you to get tests, such as:

●Imaging tests – These create pictures of the inside of your body. They can help your doctor diagnose the problem that is causing your symptoms. Standing X-rays show how aligned and stable your spine is. A CT scan shows your bones and how they line up. An MRI shows problems with nerves.

●Lab tests – Your doctor might order lab tests (such as blood or urine tests) to make sure you are ready for surgery.

Your doctor will also ask about your "health history." This involves asking about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes prescription and "over-the-counter" medicines, plus any herbal supplements. It helps to write down and bring a list of your medicines, or bring a bag with all your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

●Whether you or any of your relatives have had problems with anesthesia

You will also get information about:

●Eating and drinking before the procedure – You might need to "fast" before the procedure. This means not eating or drinking anything for a period of time. Or you might be allowed to have liquids until a short time before the procedure. Whether you need to fast, and for how long, depends on the procedure.

●Lowering the risk of infection – You might need to trim (not shave) some of your body hair before the procedure. You might also need to wash the area with a special soap.

●What help you will need when you go home – For example, you will need someone else to bring you home. If you live alone, you might want to have someone stay with you for at least a few days while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during laminectomy? — 

When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines. This is to make sure you do not feel pain during the procedure. You will most likely get "general anesthesia." This makes you unconscious so you won't feel, see, hear, or remember anything during the procedure. You might get a breathing tube to help you breathe.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●The doctor will remove part or all of your lamina.

●They will close your incisions and cover them with clean bandages.

What happens after laminectomy? — 

You will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off.

As you recover:

●You might feel groggy or confused for a short time. You might also feel nauseous or vomit. The doctor or nurse can give you medicine to help with this.

●If you had a breathing tube, you might have a sore throat. This usually gets better quickly.

●The staff will help you get out of bed and start moving around when you are ready.

●You will get medicine to help with pain, if needed. You might need other medicines, too.

●You can eat when you feel ready, but you might feel better if you start with bland foods.

What are the risks of laminectomy? — 

Your doctor will talk to you about all the possible risks, and answer your questions. Possible risks include:

●Bleeding

●Infection

●Blood clots developing in the lungs or legs

●Damage to the nerves in the spinal cord

●Leaking of the fluid surrounding the spinal cord

What else should I know? — 

Before you go home, make sure you know what problems to look out for and when to call the doctor. Make sure you understand your doctor's or nurse's instructions. Ask questions about anything you do not understand.

More on this topic

Patient education: Laminectomy – Discharge instructions (The Basics)
Patient education: Low back pain in adults (The Basics)
Patient education: Herniated disc (The Basics)
Patient education: Cauda equina syndrome (The Basics)
Patient education: Lumbar spinal stenosis (The Basics)
Patient education: Cervical spinal stenosis (The Basics)

Patient education: Low back pain in adults (Beyond the Basics)