Living with leg pain and lower back discomfort can feel overwhelming, especially when it interferes with daily activities you once enjoyed. If conservative treatments like physical therapy and medications haven’t provided lasting relief, a lumbar laminectomy may offer the solution you’ve been searching for.
Sciatica, a general term for what spine surgeons call “lumbar radiculopathy”, is characterized by radiating pain down the leg with or without low back pain. It is among the more common complaints prompting medical attention; up to 40% of patients may experience an episode (or episodes) of debilitating leg/back pain during their lifetime. If you are experiencing these symptoms, you may have spinal stenosis. If you do receive this diagnosis, consider a permanent alternative to medications.
What Is a Lumbar Laminectomy?
A lumbar laminectomy is a surgical procedure designed to remove the pressure placed on your spinal nerves due to a narrowing of the channel through which the nerves travel, known as the spinal canal or foramen. This decompression surgery relieves pain, numbness, and weakness caused by nerve compression in your lower back. This surgery is done under general anesthesia by an experienced spine surgeon.
Understanding Your Surgical Options
Depending on the location, cause, and severity of your spinal stenosis, your surgeon will use either an “open” laminectomy or a minimally invasive laminectomy. The approach selected depends on the training and expertise of the surgeon.
Open Laminectomy
In an open laminectomy, your surgeon will make a big incision along the center of the back, over the portion of your spine affected by stenosis. The muscles are stripped off the spine and retracted to expose the bone. Your surgeon will then remove the lamina, parts of the facet joints and ligament underneath the bone called the ligamentum flavum. These are the parts of the spine that have overgrown over many years and are putting pressure on your nerves.
Minimally Invasive Lumbar Laminectomy
A minimally invasive lumbar laminectomy achieves the same result, but the approach is very different. A much smaller incision is made, and the muscle is not stripped off the bone, rather, it is dilated and a “tubular retractor” is positioned over the affected area. Microscopic visualization and microsurgical techniques are used to perform the procedure, and the amount of bone removed is much less. The advantage of minimally invasive surgery is less soft tissue damage and more preservation of structure. The result is the same in terms of relief from you preoperative symptoms but with less surgical pain and quicker healing times.
When Spinal Fusion May Be Recommended
If the associated instability or the amount of bone removed to create adequate space compromises spinal stability, fusion surgery may be warranted. Your surgeon will discuss whether fusion is necessary during your consultation, based on your specific spinal condition and imaging results.
Recovery After Lumbar Laminectomy
What to Expect Immediately After Surgery
When your surgery is completed, you will be taken to a specialized area, known as the recovery room. Here you’ll be monitored while you wake up from anesthesia, and your pain medications will be adjusted to ensure you are comfortable. Once you’re fully recovered from anesthesia, you’ll either be assessed for discharge or moved to a room for the duration of your hospital stay.
Hospital Stay and Early Mobility
Whether your case requires a hospital stay will depend on your overall medical condition and the complexity of the procedure; however, many patients go home the same day following a routine minimally invasive laminectomy. Regardless, you should expect to walk on the same day of your surgery. This is critical in terms of speeding recovery times and preventing complications. During this time, you may require oral precription pain medications.
First Week at Home
Once you are home, you’ll need to rest, but you’re encouraged to remain relatively active. Short, gentle walks several times a day will help keep your muscles limber and help speed healing. Avoid any sort of strenuous activity even if you are feeling up to it. It’s a good idea to arrange to have someone help you during the first week or two of your recovery at home.
Wound Care Guidelines
24-48hrs after a minimally invasive laminectomy, your surgeon will usually give you permission to shower. Open laminectomies may require more time. Regardless of which approach you have had, soaking the incision site must be avoided unitl your surgeon gives you permission to do so. This will be for at least 7-10 days. The surgical wound should be gently patted dry and inspected following a shower. Contact your surgeon immediately if you notice the wound opening or draining.
Week 2: Building Stamina
By week two, you will start to have more energy. It may be tempting to try to accomplish more, but take it easy; your body is still healing. Lifting anything over 5 lbs. should be avoided. You can start to take longer walks to increase your stamina.
Follow-Up Care
After 3-4 weeks, you will need to return to your surgeon for your first routine postoperative visit. This will entail checking your incision site, reviewing medications, answering questions, planning next steps in your recovery, and taking X-rays if you have had implants placed at surgery.
Returning to Normal Activities
Your activity level can continue to increase as you continue to recover. If you work in a strenuous or high-impact job, you may have to wait longer to return to work or have a modified work routine. Within a month or two after minimally invasive laminectomy, you can expect to feel comfortable resuming your normal lifestyle and activities. Open laminectomy can take longer. Many patients notice significant improvement in their leg pain and mobility within the first few weeks, with continued progress over the following months.
Risks of Lumbar Laminectomy
As with all anesthetic and surgical procedures, lumbar laminectomy carries some risks. The use of specialized monitoring equipment and the hands of a skilled surgeon can reduce the chances of complications. At Neurosurgeons of New Jersey, our board-certified spine specialists use advanced techniques and technology to minimize surgical risks.
Some of the risks associated specifically with lumbar laminectomy include:
- Numbness, tingling, or weakness due to nerve damage
- Infection of the surgical site
- CSF (cerebrospinal fluid) leak
- Bleeding
- Blood clots
- Continued or worsening back pain
- hardware-related issues or failure of fusion (if fusion is performed)
Your surgical team will review all potential risks with you during your consultation and take every precaution to ensure a safe procedure and successful outcome.
Is Lumbar Laminectomy Right for Me?
You May Be a Candidate If:
If you’ve been suffering from the debilitating pain from lumbar spinal stenosis, a lumbar laminectomy may be the perfect fit for finding relief. Lumbar laminectomy is effective for those who have spinal stenosis due to degenerative disc disease. It can also benefit you if you have a narrowing of your spinal canal due to an injury or growth within the canal.
Additional conditions that may respond well to a laminectomy include:
- Herniated discs compressing spinal nerves
- Bone spurs are causing nerve impingement
- Thickened ligaments narrowing the spinal canal
When Conservative Treatments Aren’t Enough
Many patients explore non-surgical options first, including physical therapy, anti-inflammatory medications, epidural steroid injections, and activity modification. If these treatments haven’t provided adequate relief after several months, or if you’re experiencing progressive weakness or loss of function, surgery may be your best option for long-term relief.
Your surgeon can help you determine if you are a good candidate for a lumbar laminectomy. During your consultation, your spine specialist will review your medical history, examine your symptoms, assess imaging studies (such as MRI or CT scans), and discuss whether minimally invasive or traditional open surgery is most appropriate for your specific condition.
Take the Next Step Toward Relief
Lower back pain and leg pain can rob you of the active lifestyle you love. Receiving treatment for your lumbar spinal stenosis can give you your life and confidence back. Schedule a consultation with one of our experienced spine surgeons at Neurosurgeons of New Jersey to learn more about your treatment options.
Ready to explore whether a lumbar laminectomy is right for you? Contact us today to schedule a consultation at one of our convenient New Jersey or New York locations.