Cervical Laminectomy/Laminoplasty

  • What is wrong with my back?

    You have what’s commonly known as a pinched nerve. The discs are rubbery shock absorbers between the vertebrae. They are close to nerves that originate in the spine and then travel down to the legs. If the disc is damaged, part of it may bulge (herniate) or even burst free into the spinal canal. These changes put pressure on the nerve and cause leg pain, numbness or weakness. This can be produced by one or more herniated discs and/or areas of arthritis in your back. Bone spurs associated with arthritis may do the same thing.

  • What is required to fix the problem?

    The discs or bone spurs pressing on your nerve must be removed. An incision (usually two or three inches long) is made in the middle of your lower back. Then, the muscles covering the spine are moved to the side to make a small window into your spinal canal. The nerve is exposed, moved aside and protected. The protruding disc or bone spur is then removed. This decompresses the nerve and, in most cases, leads to rapid improvement in nerve pain, numbness and/or weakness. Sometimes the abnormality may extend over several disc segments, which requires a longer incision for decompression.

  • Who is a candidate for lumbar laminectomy and when is it necessary?

    The primary reason for this operation is pain that is intolerable to the patient. Sometimes increasing nerve dysfunction (particularly weakness) or loss of bowel or bladder control may make the surgery necessary even if pain is not severe. In most cases, nerve dysfunction is not severe and pain can be controlled by nonsurgical means. However, if the pain becomes intolerable, surgery is a reliable way to solve the problem. Since the patient is the one feeling the pain, the patient is usually the one who decides when he or she is ready for surgery.

  • Who performs this surgery?

    An orthopedic surgeon who specializes in spinal surgery will perform this surgery.

  • Is my entire disc removed?

    No, only the ruptured part and any other obviously abnormal disc material are removed. This generally amounts to no more than 10-15 percent of the entire disc.

  • How long will I be in the hospital?

    Laminectomy patients are usually out of bed within an hour or two after their operation. Some patients can go home on the day of surgery. The remainder usually go home the next morning.

  • Will I need a blood transfusion?

    Transfusions are rarely needed after this kind of surgery.

  • What can I do after surgery?

    You may get up and move around as soon as you feel like it, and may drive short distances when you feel able. You should avoid bending, lifting and twisting for 6 weeks to allow for healing of the surgical area.

  • When can I go back to work?

    That depends on the kind of work you do and how long your drive is. If you have a desk job and live within a 15-minute drive from your office, you may return when you feel comfortable (usually 2-3 weeks). You should not drive long distances (30 minutes or more) for about one month after surgery. If your job requires physical labor, you should consult your surgeon.

  • What is the likelihood that I will be relieved of my pain?

    90-95 percent of patients get relief of their leg pain. Some patients (about 15 percent) will continue to have noticeable back pain in some situations and may require additional treatment.

  • Could I be paralyzed from surgery?

    The chances of neurologic injury with spine surgery are very low. The possibility of catastrophic injury, such as paralysis, impotence or loss of bowel or bladder control are highly unlikely. Rarely, injury to a nerve root with isolated numbness and/or weakness in the leg is possible.

  • What other risks are there?

    There are general risks with any type of surgery. These include, but are not limited to, the possibility of a wound infection, uncontrollable bleeding, leakage of spinal fluid, collection of blood clots in the wound or in the veins of the leg, abdominal problems, pulmonary embolism (a blood clot to the lungs), and heart attack. The chances of any of these happening, particularly to a healthy patient, are low. Rarely, death may occur during or after any surgical procedure.

  • Will my back be normal after surgery?

    Though you may have excellent relief of pain, a disc is never completely normal after it has herniated. If your problem has been caused by arthritis, the arthritis cannot be cured even if the bone spurs have been removed and the nerves decompressed. Scar tissue may form around the surgically decompressed nerves, which may cause residual pain. You may have more back pain than someone who hasn’t had these spinal issues. There is also increased risk of re-herniation of the damaged disc. However, most people can resume almost all of their normal activities after recovering from surgery.

  • What should I do after surgery?

    You should resume low-impact activities as soon as possible, starting with walking. Try to walk a little farther each day, building up to a brisk three-mile walk each day by six weeks after surgery. Once your sutures are removed, you may swim, which is very back-friendly. By two or three weeks after surgery, you may try more vigorous activities, such as an exercise bike or NordicTrack. Talk to your surgeon about aerobics and jogging. Physical activity is good for you, if done properly.

  • What shouldn’t I do after surgery?

    In general, you should limit heavy lifting, bending, twisting and high impact physical activities, including contact sports. Consult your surgeon for details.

  • Could this ever happen to me again?

    Unfortunately, yes. As mentioned above, only part of the disc is removed and there is no way to return the disc to normal again, which means recurrent herniations do occasionally occur. Also, adjacent discs may be abnormal, too, and could rupture in the future.

  • Should I avoid vigorous physical activity?

    No. Exercise is good for you! You should get some sort of vigorous, low-impact aerobic exercise at least three times a week. Walking outside or on a treadmill and using an exercise bike are all examples of exercise that is appropriate for spine patients, but only when directed by your surgeon.