Lumbar Laminectomy

Overview

Lumbar laminectomy is a surgical procedure to remove the lamina (the back portion of a vertebra) to relieve pressure on the spinal cord or nerve roots. It is commonly performed to treat spinal stenosis, where narrowing of the spinal canal causes compression of neural structures. The procedure creates more space within the spinal canal to reduce symptoms of pain, numbness, and weakness.

Indications

This procedure may be considered when:

• •Lumbar spinal stenosis causing neurogenic claudication or radiculopathy
• •Significant leg pain, numbness, or weakness affecting function despite conservative treatment
• •Progressive neurological deficits
• •Cauda equina syndrome (urgent indication)
• •Central or lateral recess stenosis compressing nerve roots
• •Symptoms that significantly limit walking or daily activities

How It Works

The procedure typically involves several coordinated steps:

• •Preoperative evaluation includes imaging review to identify levels of stenosis and surgical planning
• •The procedure is performed under general anesthesia
• •An incision is made in the midline of the lower back
• •Paraspinal muscles are carefully retracted to expose the spine
• •The lamina (back part of the vertebra) is removed using specialized instruments
• •Thickened ligamentum flavum is removed to decompress the spinal canal
• •Bone spurs or hypertrophied facet joints may be trimmed if they contribute to stenosis
• •Multiple levels may be addressed if stenosis is present at several segments
• •The nerve roots are visualized and confirmed to be decompressed
• •Fusion may be added if instability is present or created by the decompression

Risks

As with any surgical procedure, potential risks include:

• •Spinal instability, particularly if multiple levels are decompressed or facets are removed
• •Recurrent stenosis from scar tissue or progressive degenerative changes
• •Dural tear with cerebrospinal fluid leak
• •Infection (wound or epidural)
• •Nerve root injury causing persistent pain, numbness, or weakness
• •Bleeding or hematoma formation
• •Incomplete relief of symptoms
• •Adjacent segment disease over time
• •General surgical risks including blood clots and anesthesia complications

Recovery Expectations

Recovery follows a gradual progression:

• •Hospital stay typically ranges from 1 to 3 days
• •Walking is usually encouraged within 24 hours after surgery
• •Activity restrictions may include limiting bending, lifting, and twisting initially
• •Leg symptoms often improve quickly, though some improvement may be gradual
• •Back pain at the surgical site is common and typically improves over weeks
• •Physical therapy may be recommended to restore strength and function
• •Return to desk work may occur within 2 to 4 weeks for many patients
• •Return to more strenuous activities may require 6 to 12 weeks
• •Full recovery may require several months

Alternatives

Depending on individual circumstances, alternatives may include:

• •Continued conservative management including physical therapy and activity modification
• •Epidural steroid injections for temporary symptom relief
• •Medications for pain and inflammation management
• •Minimally invasive decompression techniques
• •Interspinous spacer devices (indirect decompression)
• •Microdecompression or foraminotomy for more limited stenosis
• •Spinal fusion if instability is the primary concern

Sources

• Mayo Clinic – Laminectomy
• Cleveland Clinic – Laminectomy