Lumbar Laminectomy Surgery (PLD)
Sometimes known as decompression surgery, a lumbar laminectomy is performed to relieve pressure on the spinal cord or nerves. This pressure is usually caused by bony overgrowths within the spinal canal, which can be the result of spinal osteoarthritis. The surgery removes the lamina, the back part of the vertebra that covers the spinal cord.
Below are some of the most common questions we receive from patients who are considering lumbar laminectomy surgery. Please keep in mind that the recovery from surgery is unique to each individual and affected by various factors such as patient age, comorbid illnesses, the degree of the spinal cord or nerve impingement, the length of illness prior to surgery, as well as the degree of disability prior to surgery, just to name a few mitigating factors. The answers below are responses to questions we receive from the average patient.
Why Would I Need A Lumbar Laminectomy?
When a vertebra develops a growth such as a bone spur within the spinal canal, it shrinks the space available for the spinal cord and the nerves. This can create pressure (compression) on those nerves that causes pain, weakness, or numbness that can radiate down the patient’s arms and legs. If not treated, the compression can lead to loss of function and permanent nerve damage.
A laminectomy may also be necessary in herniated disc surgery to gain access to the damaged disc.
Dr. Albert may recommend a laminectomy if:
- Conservative treatments such as physical therapy don’t improve symptoms
- You have muscle weakness or numbness that is making walking or even standing difficult
- You are experiencing loss of bladder and bowel control
Lumbar Laminectomy Surgery
While a patient is under general anesthesia, a laminectomy is performed to the affected area of the back. After making an incision, muscles and ligaments are retracted in order to gain access to the spine. An x-ray device used during surgery helps visualize the structures of the vertebrae and accurately locates the area needing surgery.
Based on the extent of damage, the lamina may need either partial or full removal on both sides of the spine. Removing the lamina and other debris alleviates the spinal cord and nerve compression and symptoms improve. The procedure lasts from 1 to 3 hours on average.
Is This Surgery Very Painful?
Please keep in mind that pain is a very subjective experience and one’s reaction to surgery is affected by a variety of factors as mentioned above. It is not uncommon for a patient to experience “reminder” symptoms after surgery. These symptoms can often feel similar to the patient’s preoperative symptoms but not as intense. This is very common as patients recover. However, if you are concerned, please call the office to discuss your symptoms and concerns.
Lumbar Laminectomy Recovery
The first visit is approximately two weeks after surgery. If we think we should see you in the office we will schedule an earlier appointment. Patients will require a formalized outpatient physical therapy program after a laminectomy procedure.
Most patients do not have sutures that require removal. There are internal sutures that will dissolve with time. There will also be steri-strips (white pieces of tape) over the incision that will either fall off or will be removed in the office.
For the first two weeks, your activity is limited to walking. We encourage you to walk as much as you are comfortable. During this time you may go up and down stairs, with the use of a railing, and you may also sleep in a normal bed. You will have a five-pound lifting limit for the first two weeks. After two weeks you will be able to resume low-impact cardiovascular activities and increase the amount of weight you are lifting. Within a reasonable amount of time after surgery, you will have very few restrictions on your activities. Please be sure to discuss any specific questions with us in the office.
What Results Can I Expect After My Laminectomy?
Laminectomy is very successful at relieving much of the pain and numbness that was caused by the nerve and/or spinal cord compression. Any weakness in the extremities that was linked to the compression should, for the most part, be alleviated. Laminectomy is better at improving leg pain caused by a compressed nerve than back pain.
However, the surgery won’t stop the process of aging on the spine. Plus, if spinal osteoarthritis was to blame, surgery won’t stop future buildup of bony growths. But, in the vertebra where the lamina was removed, a return to compression is unlikely.
Since a laminectomy is a spinal procedure, it carries some risks. Some complications may include blood clot formation, postsurgical infection, nerve damage, breathing problems, or adverse reactions to medication/anesthesia. Despite the risks, the great majority of laminectomy surgeries are successful and uneventful.
What Do I Need To Do To Prepare For This Surgery?
The preparation for this surgery is the same as any major surgery. We ask that you refrain from taking any non-steroidal, anti-inflammatory medicines, and certain supplements 10 days before your surgery such as:
- Aspirin, Advil, Aleve
- Herbal supplements
- Vitamins E & K
- Fish oil
If you have a physician who recommends that you do not stop taking aspirin prior to surgery, please be sure to discuss this with our office.
If you smoke, you’ll need to stop for at least two weeks prior to your surgery. This helps strengthen your immune system and overall healing.
How long will I be out of work?
The average length of time out of work after a laminectomy surgery is from 1-4 weeks. Patients who perform labor-intensive jobs are more likely to be out of work closer to four weeks.
When will I be able to drive?
Most patients are able to begin driving short distances from one to two weeks after surgery. You may be a passenger in a car as soon as you feel up to it. We do advise that you refrain from driving while you are taking narcotic pain medication.