Lumbar Laminectomy
An Overview
Lumbar spinal stenosis is a common cause of low back and leg pain, or sciatica. As we age, the normal wear-and-tear effects of aging can lead to narrowing of the spinal canal, which houses the spinal nerves and spinal cord. This condition is called spinal stenosis. Degenerative changes of the spine are seen in up to 95% of people by the age of 50. Spinal stenosis most often occurs in adults over 60. Pressure on the nerve roots is equally common in men and women.
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A small number of people are born with back problems that develop into lumbar spinal stenosis. This is known as congenital spinal stenosis. Typically, this occurs in people who are born with a smaller spinal canal; because there is
less space within the canal, degeneration, or arthritis, can affect them sooner. Congenital spinal stenosis occurs most often in men. People usually first notice symptoms between the ages of 30 and 50.
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Laminectomy involves removing the bone, bone spurs, and ligaments that are compressing the nerves. This procedure may also be called a decompression. Laminectomy can be performed as open surgery, in which your doctor uses a single, larger incision to access your spine. The procedure can also be done using a minimally invasive method, where several smaller incisions are made. Dr Akamnonu will discuss the right option for you.
Rehabilitation
After surgery, you may stay in the hospital for a short time, depending on your health and the procedure performed. Healthy people who undergo decompression alone may go home the same or next day, and may return to normal activities after only a few weeks. Fusion generally adds 2 to 3 days to the hospital stay.
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Dr Akamnonu may give you a brace or corset to wear for comfort. They will likely encourage you to begin walking as soon as possible. Most people only need physical therapy to strengthen their backs.
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Your physical therapist may show you exercises to help you build and maintain strength, endurance, and flexibility for spinal stability. Some of these exercises will help strengthen your abdominal muscles, which help support your back. Your physical therapist will create an individualized program, taking into consideration your health and history.
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Most people can go back to a desk job within a few days to a few weeks after surgery. They may return to normal activities after 2 to 3 months. Older patients who need more care and assistance may be transferred from the hospital to a rehabilitation facility prior to going home.
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Postoperative opioid medication. For people who are not on opioids before surgery, a short course (a few weeks) of opioids is typical after a laminectomy. After a fusion procedure, the duration may be longer. If you have been on opioids for a long period of time prior to surgery, you may still be on them after surgery, as your body is used to the pain medication.