Spinal Stenosis Operation (Laminectomy)

About the Procedure

A laminectomy is an orthopedic surgical operation whose purpose is primarily to treat patients suffering from a common condition called spinal stenosis. Spinal stenosis occurs when an increase in bone matter within the spinal column results in increased pressure being put upon the spinal cord and its connected nerves. This condition can present with different symptoms depending on the location along the spinal column in which it occurs. Most commonly, these symptoms include chronic back pain, numbness or weakness in the arms or legs and intermittent loss of control over bowel and urinary functions. Left untreated, spinal stenosis can result in partial or complete paralysis, though this is not common. The most common cause of spinal stenosis is the natural degeneration of bone structure and uniformity associated with aging.

The objective of a laminectomy is to decompress the pinched section of the spinal cord by removing the lamina, which is the posterior inner wall of the vertebrae. Removing it creates more space within the spinal canal, relieving or “decompressing” the pressure being put on the spinal cord within.

First the patient is put under general anesthesia and placed on their stomach on the operating table. Then the spine is accessed by making an incision of up to 5 inches long. Some muscle or connective tissue may need to be removed or pushed aside depending on the exact location of the surgery. Once access is gained to the spine, a section or the entirety of the lamina is cut out and removed. The exact amount of bone matter removed is variable. Sometimes it is only necessary to remove a small portion of the lamina. In more extreme cases, not only is the lamina removed but sections of the bone on the posterior of the spine may be removed as well. Once the necessary amount has been excised, the surgical wound is sewn up and the operation is complete.

What to Know Before the Procedure

Several important considerations exist for patients considering a laminectomy to treat spinal stenosis. As with all major forms of orthopedic surgery, it should always be a last resort after all conservative, non-surgical approaches have failed. If back pain is the only symptom of spinal stenosis being suffered, then treatments such as pain medication or physical therapy may be better options.

Something else to be discussed with your doctor is the volume of bone matter to be excised. While removing more will relieve a greater amount of pressure, it will also dramatically extend the period of recovery and rehabilitation after the surgery. The cost in time and discomfort should be weighed against the potential benefits of the surgery.

It should also be noted that a laminectomy alone may not be sufficient to relieve the pressure and stabilize the spine. Spinal fusion surgery is often performed in concert with a laminectomy to yield optimal spinal stability. As spinal fusion is an extensive form of surgery, having it done in addition to the laminectomy will also greatly extend the duration of the patient's recovery period, to as long as a year in some cases. All of these issues should be discussed thoroughly with your doctor before proceeding with the surgery.

What to Know After the Procedure

After the surgery, the patient will remain in the hospital for observation for several days before being discharged. It is common for the patient to experience pain and discomfort at the surgical site. As this can last for weeks, pain medication is often prescribed to help the patient manage the discomfort.

The duration of the recovery period, the necessity for physical therapy and the overall time line for returning to certain levels of activity are different for every patient depending on overall health and the severity of the surgery performed. Consult your doctor in all of these matters and always adhere strictly to his or her counsel. Failure to do so can have serious negative ramifications for your overall health. It may take up to a year before the full benefits of the surgery are apparent and normal activity levels become possible.

If you Need to Travel Outside of your Local Hospital

Laminectomy is considered an elective procedure by many health insurance companies and as such, it may require the patient to pay out of pocket. As with other forms of spinal surgery, it can be extraordinarily expensive. Spinal surgery is also very delicate in nature and should only be performed by the most highly qualified surgeons; as even the slightest error can have severe medical consequences. Due to these factors, it makes sense to search every region for the most qualified individual. Having the procedure performed in a foreign market can save the patient tens of thousands of dollars. No amount of travel should be considered excessive in order to be in the hands of the most qualified individual.