Lumbar Laminectomy

A lumbar laminectomy is primarily used to treat spinal stenosis, a condition in which the spinal canal narrows and compresses the nerve roots. This can result in pain, tingling, weakness, and difficulty walking from neurogenic claudication. Many patients describe pain, cramping, numbness, and a heavy sensation in the buttocks and legs worse with standing and walking. This pain is typically relieved with leaning forward, sitting, and rest.

Causes of lumbar stenosis:

• Degenerative disc disease (DDD): where the gradual breakdown of intervertebral discs leads to disc bulging and narrowing of the spinal canal
• Herniated discs: where the inner portion of an intervertebral disc protrudes through its outer layer, narrows the spinal canal, and presses on nearby nerve roots
• Spondylosis (arthritis): thickened ligaments and bone spurs that lead to narrowing of the spinal canal and nerve compression.

1. A lumbar laminectomy is considered when non-surgical treatments fail to provide relief. Conservative treatments such as physical therapy, anti-inflammatory medications, steroid injections, and activity modification are typically the first line of defense against spinal stenosis and nerve compression.
2. Surgery may be recommended if pain, numbness, or weakness in the legs worsens, limiting mobility and daily activities.
3. When symptoms persist despite several weeks to months of non-surgical treatment.
4. Bowel or bladder dysfunction occurs (a possible sign of cauda equina syndrome, which requires emergency surgical intervention); or
5. Compression causes difficulty with standing or walking.

Dr. Lauren Boden carefully evaluates each patient’s symptoms, medical history, and imaging studies (such as X-rays and MRIs) to determine whether a lumbar laminectomy is the best course of action.

A good candidate for a lumbar laminectomy is someone experiencing significant nerve-related symptoms that interfere with their daily life. Ideal candidates include patients with confirmed spinal stenosis causing nerve compression without evidence of instability, individuals whose symptoms have not improved with conservative treatments like physical therapy or medications, patients with difficulty walking or standing due to nerve-related pain, and those who are in overall good health and do not have medical conditions that would increase surgical risks. However, certain patients may not be ideal candidates, including those with severe osteoporosis, spinal instability, uncontrolled diabetes, or other conditions that may impair healing. Dr. Boden carefully evaluates each patient’s individual health status and goals before recommending surgery.

A lumbar laminectomy is typically performed under general anesthesia. The procedure involves making a small incision in the lower back, directly over the affected area of the spine. The lamina is carefully removed to relieve pressure on the spinal cord and nerve roots. Bone spurs, herniated disc material, or thickened ligaments that contribute to nerve compression are also removed. The incision is then closed with sutures, and the patient is monitored in recovery. Depending on the severity of the condition, minimally invasive techniques may be used to reduce muscle damage, minimize scarring, and speed up recovery.

Recovery from a lumbar laminectomy varies depending on the patient’s age, overall health, and the extent of the surgery. Many patients go home the same day if the procedure is minimally invasive or involves only 1-2 levels, while others may stay overnight for monitoring.

Pain management includes tylenol, muscle relaxers, and anti-inflammatory medications to control discomfort. A short course of stronger pain relievers are used as needed. Walking is encouraged soon after surgery to prevent stiffness and blood clots. In the first few weeks after surgery, patients are advised to avoid heavy lifting, bending, or twisting to protect the healing spine. Walking is encouraged after surgery to assist in the healing process and prevent post-operative complications. Physical therapy may be started 6 weeks after surgery if needed to promote mobility and strengthen the lower back muscles. Some discomfort and fatigue are normal but improve over time. Activity restrictions are typically lifted after the first six weeks, and patients can begin to resume their normal activity levels at that time.Dr. Lauren Boden works closely with each patient throughout the recovery process to ensure optimal outcomes and prevent complications.