Lumbar Discectomy and Laminectomy

Back pain and problems with your legs could be caused by pressure on one of the nerves in your spine.  This pressure can be caused by an abnormal bone growth (spur) on one of your spinal bones, which is a condition known as spinal stenosis.  This pressure can also be caused by a bulging or herniated spinal disc.  Both problems can cause pain, burning, tingling or numbness in your back and/or your legs.

Symptoms of spinal stenosis and herniated discs can include:

• back pain
• leg pain
• leg numbness
• difficulty walking

Spinal Stenosis and Herniated Discs can be identified using:

• Magnetic Resonance Imagine (MRI)
• Computerized Tomography (CT)
• Electromyography (EMG)

Lumbar Laminectomy

A lumbar laminectomy is a neurosurgical procedure that relieves pressure on spinal nerves caused by wear and tear on portions of the spine that can create bony spurs or protrusions.  A laminectomy involves removing a small section of the bony covering over the back of the spinal canal (lamina), helping to relieve pressure on spinal nerves.  This procedure enlarges the spinal canal so nerves have more room.

Lumbar Discectomy

A lumbar discectomy is a neurosurgical procedure that repairs a bulging or herniated (vertebral) disc in your spine.  A laminectomy is performed first to gain access to the injured portion of the disc.  Then the outer wall and soft center of the injured disc that is bulged or herniated can be removed relieving pressure on affected nerves. 

About Discectomy and Laminectomy Surgery

For most neuro-spine surgeries, patients are given general anesthesia to put them to sleep.  However, some neurosurgeons use spinal anesthesia instead, which is injected in the low back into the space around the spinal cord.  This numbs the spine and lower limbs for the duration of your surgery.  With spinal anesthesia, patients are also given medication to keep them sedated during the procedure.  Talk with your neurosurgeon about the specific anesthesia you will receive for your surgery.

Patients are placed on a special operating room bed that allows for optimal access to the spine and room for the surgeon to work and helps greatly reduce the potential for blood loss.

Your doctor will make a short incision in your back, usually 1.5 inches long, to expose the correct area of the spine.  An X-ray is used in the operating room to ensure that the correct bone/disc(s) is operated upon.  Some neurosurgeons may also use a special microscope during surgery to magnify the area they are operating upon.

Your neurosurgeon may use small cutting instruments to carefully remove soft tissue near the spinal nerves.  Then the surgeon removes a small portion of the lamina bone and/or disc if necessary, takes out any disc fragments and eliminates any nearby bone spurs.  Once this is complete, the muscles and soft tissue is put back into place and the skin is closed with sutures, staples, skin glue or steri-strips (small pieces of tape).

This type of neurosurgery can last anywhere from 1 to 3 hours, depending on how many levels of the spine are injured.  Your doctor can give you a more accurate assessment of surgical length.

Discectomy and Laminectomy Hospital Recovery

Your length of recovery time in the hospital will depend on the reason that you needed to have a laminectomy and/or discectomy.  Most patients go home the day after surgery, but your neurosurgeon will decide when you are ready for discharge.

If you require rehab before going home, a doctor from the Physical Medicine and Rehabilitation department will see you and make specific recommendations regarding your discharge.

In order to go home, you need to be able to walk, eat, urinate and have a healing wound.

Discectomy and Laminectomy Recovery at Home

• You should continue to gradually increase your activity and walking within and outside the home is encouraged.
• Avoid lifting and strenuous activity
  • Do not lift objects greater than 10lbs until advised by your doctor
  • Avoid lifting above the waist level and above your head for any prolonged period of time
• You are not allowed to drive a car. Your doctor will give you specific instructions about driving on discharge or when you follow-up in the office. You can ride as a passenger in a car as directed.
• Climbing stairs at home is permitted and tolerated with caution.
• Sexual activity may resume when indicated by your doctor.
• Remember to call and schedule your follow-up appointment with your doctor once you are at home

Wound Care

• You may shower, but avoid bathtubs, whirlpools and swimming pools until cleared with your doctor.
• If you have steri-strips (strips of tape), cover your incision as directed by your doctor. You or a companion may remove the tapes as directed. If your tapes do get wet, you may pat tapes dry or use hair dryer on cool setting.
• If you have staples, you may shower but do not scrub over incision.
• DO NOT apply lotions or creams near incision site.

Contact your doctor immediately if you have:

• Swelling on or around the incision
• Incision becomes red and hot or has drainage
• Difficulty breathing or chest pain
• Swelling or tenderness in your legs or calves
• Fever of 100° or higher