Before the operation

The doctor should run some tests prior to surgery to aid diagnosis and to be sure what structures are involved. These tests may include:

• Spinal x-ray
• Myelogram
• Computerized tomography (CT) scan
• Magnetic resonance imaging (MRI) scan

A few days before the surgery, the patient should meet with the anesthesiologist to discuss whether to have general anesthesia or spinal anesthesia. Age should not be a factor in deciding whether to have laminectomy. However, if patient has other medical conditions that might make this procedure less successful, surgery should be avoided.

The operation procedure

In most cases, patient is placed in a kneeling position to reduce the weight of abdomen on spine. Many people think that laminectomy and microdiscectomy are two same things. Lumbar laminectomy differs from microdiscectomy in that the incision is longer and there is more muscle stripping. The back is approached through a 2-5 inch long incision in the midline of the back. The left and right back muscles are dissected off the lamina on both sides and at multiple levels. Then doctor removes the ligament joining the vertebrae along with all or part of the lamina. The goal is to see the involved nerve root. After the spine is approached, the lamina is removed which allows visualization of the nerve roots. The doctor pulls the nerve root back toward the center of spinal column and removes the disk or part of the disk. Although the surgery takes 1-3 hours, patients lose very little blood.

Post – operative care

Patients usually stay in the hospital for one to three days but the patient's return to normal activity is largely dependent on his or her pre-operative condition and age. In the first few days after the procedure anything harder then walking is not recommended. Excessive bending, lifting or twisting is forbidden for six weeks in order to avoid pulling on the suture line before it heals. Muscle spasms are quite common following laminectomy. Pain relief is ordered and given regularly.

Possible post-op pain

It is completely normal to have some pain after operation. This is caused by swelling of the previously compressed nerve as well as from surgery itself. There may also be some muscle spasms across the back and down the legs. 

Laminectomy success rate

The success rate of a laminectomy is good and approximately 70% to 80% of patients will have significant improvement. Laminectomy results are much better for relief of leg pain then for relief of lower back pain. Unfortunately, the symptoms may recur after several years as the degenerative process that originally produced the spinal stenosis continues. Another operation that could be helpful is fusing the joint. Fusing the joint prevents the spinal stenosis from recurring and can help eliminate pain from an unstable segment. Fusion surgery is especially useful if there is a degenerative spondylolisthesis associated with the stenosis.