Sciatica, symptoms radiating down a person’s legs with or without low back pain, is one of the more common complaints causing a person to seek 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 symptoms due to spinal stenosis, it may be time to consider a permanent alternative to medications.
What Is 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 surgery is done under general anesthesia by an experienced spine surgeon.
Depending on the location, cause, and severity of your spinal stenosis, your surgeon will use either an “open” laminectomy or a minimally invasive laminectomy. If it is decided that an open laminectomy is the best option (this is often the case when multiple areas are affected), your surgeon will create an incision along the center of the back, over the portion of your spine affected by stenosis. The muscles are carefully detached and moved away from the spine. Using a special cutting instrument, your surgeon will cut through the lamina, the roof of the spinal canal, which will allow removal of the portion of bone where the stenosis is occurring.
A minimally invasive lumbar laminectomy uses the same principles, but the approach is slightly different. Relatively small incisions are made near the affected spinal segments, and a “tubular retractor” is positioned over the affected area. Microscopic visualization and microsurgical techniques are used to perform the procedure, and the bony tissue is removed without creating a large incision. The advantage to minimally invasive surgery is less tissue damage, potentially less pain, and quicker healing times.
If due to associated instability or the amount of bone removed to create adequate space will compromise the stability of the spine, a fusion surgery may be warranted.
Recovery After Lumbar Laminectomy
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 ready, you’ll be moved to a room for the duration of your hospital stay.
The length of your hospital stay will depend on the complexity of the procedure, however, most patients may go home the same day as surgery following a routine minimally invasive laminectomy. You can expect to walk the day of your surgery. Small amounts of very light activity help increase circulation and aid in healing. During this time, you will likely require oral pain medications.
Once you are home, you’ll need to rest but 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 or taxing task. It’s a good idea to arrange to have someone help you during the first week, or longer, of your recovery at home.
After several days, it is fine to shower, but soaking the incision site should be avoided for at least 7-10 days. The surgical wound should be gently patted dry and inspected following a shower.
By week two, you will start to have more energy. It is tempting to try and accomplish more, but take it easy — your body is only beginning to heal. Lifting anything over 5 lbs. should be avoided. You can start to take longer walks to increase your stamina.
Between weeks 4 and 6, you will need to return to your surgeon for a follow-up visit. This will entail checking your incision site, answering questions and possibly taking X-rays to monitor the spinal stability.
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 three to six months, you can expect to feel comfortable to resume your normal lifestyle and activities.
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. 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
- Blood clots
- Continued or worsening back pain
Is Lumbar Laminectomy Right for Me?
If you’ve been suffering from the debilitating pain from lumbar spinal stenosis, lumbar laminectomy may be the perfect fit for finding relief. Lumbar laminectomy is particularly effective for those that 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. Your surgeon can help you determine if you are a good candidate for lumbar laminectomy.
Lower back 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.