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Laminectomy


Why is this procedure done?


The backbone or spine is made of many small bones called vertebrae. The spinal cord is inside of these bones. The nerves that go to other parts of your body exit in between the bones. The spinal bones are separated by spongy discs that help the vertebrae move smoothly. ‚  
Pressure on the nerves as they come out of the backbone may cause you to have pain in your back, arms, or legs. You may also have numbness or weakness. The pressure can come from many things such as: ‚  
  • Discs between your vertebrae can become flat or thinner as we get older
  • Injury may also damage the disc.
  • Extra area of bone may grow on the vertebrae. These are called bone spurs.
  • Ligaments, or strong bands of tissue that connect bones together, get larger as we age and can narrow the space where nerves come out of the spine.

The lamina is on the back part of the spinal bone that surrounds the spinal cord. Back surgery to take off this part of the bone from the vertebrae is a laminectomy. This surgery will give the discs and nerves more space. The goal is to prevent any more damage from happening. Your doctor will do this surgery only after other treatments, such as drugs and physical therapy, have been tried first. ‚  


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What will the results be?


After surgery, you should have less pain or other signs. You should be able to move more easily too. ‚  

What happens before the procedure?


  • Your doctor will take your history. Talk to the doctor about:
    • All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
    • Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
    • What time you need to stop eating or drinking before your procedure.
  • Your doctor will do an exam and may order:
    • X-rays
    • MRI scan
  • You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.

What happens during the procedure?


  • Once you are in the operating room, the staff will put an I.V. in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. It will also help you stay pain free during the surgery.
  • Sometimes, the doctor will give you a special drug to make you numb for the surgery. Other times, you are fully asleep.
  • This surgery can be done in one of two ways.
    • Open surgery ¢ ˆ ’ Your doctor will make a cut on your lower back along the spine. Your doctor will move the muscles apart to show the bones of your spine.
    • Laparoscopic surgery ¢ ˆ ’ Your doctor will make few small cuts on your lower back. Your doctor will put a scope with a tiny camera into one of the small cuts. The camera will let your doctor see the bones of your spine. Your doctor will put small surgical tools into the holes to do the procedure.
  • Your doctor will remove the lamina part of your vertebra to take pressure off the nerves and spinal cord below it.
  • Your doctor may also remove the damaged disc.
  • Sometimes, your doctor will do spinal fusion, joining two or more vertebrae together. This is done to limit movement of the bones to support the spine.
  • Your doctor will close your cut with stitches or staples and cover it with clean bandages.
  • The length of the procedure will depend on the type of surgery. It is often 1 to 3 hours.

What happens after the procedure?


  • You will go to the Recovery Room for a few hours. The staff will watch you closely. Your doctor may give you drugs for pain.
  • Your doctor may put a brace or cast on you to hold your spine in place while healing.
  • You may go home right after the surgery or you may need to stay in the hospital for 1 to 3 days based on your condition.

What drugs may be needed?


Your doctor may order drugs to: ‚  
  • Help with pain
  • Prevent infection

What problems could happen?


  • Infection
  • Nerve damage
  • Blood clots
  • Bleeding
  • Tear of the covering around the nerves called a dural tear
  • Bones do not heal well or you still have pain after the surgery

What can be done to prevent this health problem?


  • Do weight-bearing and strengthening exercises as directed by your doctor or therapist.
  • Keep a healthy weight. This can help prevent straining and pressure on your lower back.
  • Practice good ways to lift things so that you do not hurt your spine. Part of your physical therapy will be to teach you safe ways to move and lift things.
  • Quit smoking. Smoking reduces the oxygen supply to the discs in your back which can cause more bone collapse.
  • Reduce stress and worry. Stress can make your muscles tense and increase back pain.

Where can I learn more?


American Academy of Orthopaedic Surgeons ‚  
http://orthoinfo.aaos.org/topic.cfm?topic=A00329 ‚  
Better Health Channel ‚  
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Laminectomy ‚  

Consumer Information Use and Disclaimer


This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚  

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