What is Laminectomy

Laminectomy is a surgery to remove:

• Small pieces of bone in the spine (lamina).
• Tough, cord-like tissues that connect bones to other bones (ligaments) underneath the lamina. These ligaments connect the bones in the spine (vertebrae).
• Parts of joints in the spine (facet joints) that have grown too large.

The goals of this surgery are:

• To reduce pressure on nerves and the spinal cord.
• To reduce pain, numbness, and discomfort.

You may need this procedure if you have narrowing of the spinal canal (spinal stenosis) or if you have a spinal tumor, spinal injury, or Paget disease of bone.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have, including a cold or any infections.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines or dyes.
• Damage to other structures or organs, such as nerves. Nerve damage can cause pain, weakness, or numbness.
• Leaking of spinal fluid.
• A blood clot in a leg. The clot can move to the lungs, which can be very serious.
• Inability to control when you urinate (urinary incontinence) or when you have bowel movements (fecal incontinence). This is rare.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 24 hours before the procedure – stop drinking alcohol.
• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners. If your health care provider asks you to keep taking some medicines, take them with a sip of water.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• You may be given antibiotic medicine to help prevent infection.

General instructions

• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes, for at least 2 weeks before the procedure. If you need help quitting, ask your health care provider.
• Ask your health care provider how your surgical site will be marked or identified.
• You may have tests done, such as blood tests or an electrocardiogram (ECG).
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.
• Plan to have someone:
  • Take you home from the hospital or clinic.
  • Help you at home for the first week after the procedure.

What happens during the procedure?

• To reduce your risk of infection, your health care team will wash or sanitize their hands.
• Small monitors will be placed on your body to check your heart rate, blood pressure, and oxygen level.
• An IV tube will be inserted into one of your veins.
• You will be given a medicine to make you fall asleep (general anesthetic). You may also be given a medicine to help you relax (sedative).
• A breathing tube will be placed into your lungs.
• Your back will be cleaned with a germ-killing solution.
• An incision will be made in your back. The incision may be 2–5 inches (5–13 cm) long, depending on how many vertebrae are being operated on.
• Muscles in your back will be moved away from the vertebrae and pulled to the side.
• Pieces of lamina will be removed.
• Ligaments and thickened facet joints will be removed. How much tissue and bone is removed depends on how much of the tissue is putting pressure on your nerves.
• Your nerves will be identified and evaluated to check for excessive tightness.
• Your back muscles will be moved back into their normal position.
• The area under your skin will be closed with small, dissolvable stitches (sutures).
• Your skin will be closed with small, absorbable sutures or staples.
• A bandage (dressing) will be placed over your incision.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• You may continue receive medicines and fluids through an IV tube.
• You will have some back pain. You will be given pain medicine as needed.
• It is important to be up and moving as soon as possible after this procedure. Physical therapists will help you start walking.
• To prevent blood clots in your legs:
  • You may have to wear compression stockings. These stockings also reduce swelling in your legs.
  • You may need to take medicines.
• You may need to do breathing exercises to help prevent lung infection.
• Do not drive for 24 hours if you received a sedative.

Summary

• Laminectomy is a procedure that is done to reduce pressure on nerves and the spinal cord and to reduce pain, numbness, and discomfort.
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.
• You will have some back pain. You will be given pain medicine as needed.
• It is important to be up and moving as soon as possible after this procedure. Physical therapists will help you start walking.

Laminectomy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Some pain around your incision area.
• Muscle tightening (spasms) across the back.

Follow these instructions at home:

Incision care

• Follow instructions from your health care provider about how to take care of your incision area. Make sure you:
  • Wash your hands with soap and water before and after you apply medicine to the area or change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, use it as told by your health care provider. Do not stop using the antibiotic even if you start to feel better.

Bathing

• Do not take baths, swim, or use a hot tub for 2 weeks, or until your incision has healed completely.
• If your health care provider approves, you may take showers after your dressing has been removed.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Avoid bending or twisting at your waist. Always bend at your knees.
• Do not sit for more than 20–30 minutes at a time. Lie down or walk between periods of sitting.
• Do not lift anything that is heavier than 10 lb (4.5 kg) or the limit that your health care provider tells you, until he or she says that it is safe.
• Do not drive for 2 weeks after your procedure or for as long as your health care provider tells you.
• Do not drive or use heavy machinery while taking prescription pain medicine.

General instructions

• To prevent or treat constipation while you are taking prescription pain medicine, your health care provider may recommend that you:
  • Drink enough fluid to keep your urine clear or pale yellow.
  • Take over-the-counter or prescription medicines.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.
• Do breathing exercises as told.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have more redness, swelling, or pain around your incision area.
• Your incision feels warm to the touch.
• You are not able to return to activities or do exercises as told by your health care provider.

Get help right away if:

• You have:
  • More fluid or blood coming from your incision area.
  • Pus or a bad smell coming from your incision area.
  • Chills or a fever.
  • Episodes of dizziness or fainting while standing.
• You develop a rash.
• You develop shortness of breath or you have difficulty breathing.
• You cannot control when you urinate or have a bowel movement.
• You become weak.
• You are not able to use your legs.

Summary

• After the procedure, it is common to have some pain around your incision area. You may also have muscle tightening (spasms) across the back.
• Follow instructions from your health care provider about how to care for your incision.
• Do not lift anything that is heavier than 10 lb (4.5 kg) or the limit that your health care provider tells you, until he or she says that it is safe.
• Contact your health care provider if you have more redness, swelling, or pain around your incision area or if your incision feels warm to the touch. These can be signs of infection.