03-Laminectomy

The events preceding a laminectomy can be dramatic — such as when a patient experiences intense and unremitting pain in the extremities.

Or when numbness and tingling in those areas graduates to full on muscle weakness — or worse, complete paralysis.

These and other symptoms may indicate the spinal cord and nerves are compressed, and one way to relieve that pressure is with a laminectomy.

HOW DOES SPINAL COMPRESSION HAPPEN?

Imagine your spinal canal as a tunnel that houses your spinal cord. Snaking in and out of that tunnel is an intricate system of nerves.

With age and normal wear and tear — or as a result of other conditions — that tunnel may narrow (a condition called stenosis).

Stenosis places pressure on the spinal cord and nerves, a process that can lead to a wide range of neurologic problems.

Other conditions that may compress the spinal canal:

WHAT ARE SOME COMMON SYMPTOMS THAT MAY INDICATE STENOSIS?

Some troubling indications of stenosis include when a patient develops difficulty with coordination — or new difficulty controlling their bladder or bowels.

Other common symptoms include:

  • Pain
  • Numbness, tingling
  • Weakness in arms, legs or throughout the body
  • Bladder or bowel dysfunction
  • Decrease in fine motor function (e.g.: handwriting getting worse, dropping objects, worsening balance)

HOW DOES REMOVING THE LAMINA HELP?

To picture the lamina, imagine a person standing in profile.

If you could peer inside their body and zoom in on the spinal structures, you would see bones called vertebrae stacked on top of one another, forming four distinct curves.

The outer, bony section of the vertebrae — the part that sticks out and is closest to the skin — is called the lamina.

Now imagine the tunnel again.

An open tunnel — where the spinal cord and nerves have space and get proper blood flow — is normal. A narrow tunnel is not.

Removing the lamina creates vital space; it re-opens the tunnel.

HOW IS LAMINECTOMY SURGERY PERFORMED?

A small incision is made near the affected spinal region.

The surgeon then carefully dissects back skin, fat, muscle and ligaments to expose the bony back part of the spine.

Once the area is clear, the lamina and any connected ligaments are removed.

The length of the surgery depends on how many levels of the spine are stenosed.

Many patients have spinal cord and nerve root compression at multiple levels (or need procedures such as a discectomy or spinal fusion to be performed simultaneously), which can lengthen the procedure.

HOW DO I KNOW IF I NEED LAMINECTOMY?

If you have severe and unrelenting pain that has not responded to non-surgical therapies you may need a laminectomy.

Other symptoms that may require a laminectomy include:

  • Getting injections and experiencing no relief
  • Taking multiple narcotic pain medications with no relief
  • Trying physical therapy with little to no effect

Patients experiencing bladder and bowel control problems, muscle weakness, or worsening fine motor function need immediate surgery.

WHAT ARE THE RISKS OF A LAMINECTOMY?

Typical surgical risks include reactions to anesthesia, infection or excessive bleeding.

Risks specific to surgeries performed around nerves and the spinal cord include:

  • Worsening pain, numbness, tingling
  • Temporary or permanent paralysis
  • Total loss of bladder and bowel function
  • Damage to the dura which may lead to a spinal fluid leak and risk of meningitis

AFTER SURGERY WHEN WILL I BE BACK TO MY NORMAL ACTIVITIES?

Patients tend to resume normal activities 6-12 weeks post-surgery.

Patients whose jobs require heavy lifting, driving or sitting for prolonged periods may need more time to heal.

For those whose work does not involve heavy lifting or exertion, a return to normal activities can occur after just a few weeks.

Determining when a patient can resume day-to-day activities also depends on how extensive the surgery was.

If you suspect a serious condition is causing your neck or back pain, please see a spine specialist. Contact us online or give us a call at 323-319-2897 and we will be happy to help.