Watkins Medical Centre
Level 8, 225 Wickham Terrace,
Spring Hill QLD, 4000

All appointments
Phone: (07) 3831 7034

Laminectomy

Laminectomy is a general term for decompression of spinal stenosis. Literally, the term means removal of the lamina. The lamina is the part of the bone at the back of the spinal canal that completes the 'roof' of the spinal canal.

 


The laminectomy can be complete or partial. Complete laminectomy is usually only done for severe compression or to gain access to the spinal cord (or cauda equina) for more serious problems, such as spinal cord or vertebral tumours. Usually a partial decompression is performed. This involves removing only a portion of the lamina. The general term 'spinal decompresison' is used to denote doing whatever is neccessary to relieve the pressure on the nerves.

 

Complications

  1. Nerve damage
  2. Infection
  3. Failure to relieve pain
  4. Recurrent spinal stenosis over time
  5. Cerebrospinal fluid leak

Post operative course

Usually you will wake and the leg pain will have gone. It is usual that some pins and needles may be present and even that these may be worse after the surgery. These usually settle in a few days. There will be some wound pain, though for the first few hours this is usually controlled by local anaesthetic that is injected into the wound at the end of the procedure. After this wears off pain control is usually managed by a patient controlled analgesia device (PCA) There will usually be a wound drain. The PCA and the wound drain are usually removed after 24 hours. After that pain control is usually by a tablet or injection. You are then encouraged to get out of bed and to mobilize. Usually an increased ability to walk further without leg pain is noticed immediatley. You can be discharged when you are comfortable and independant enough to do so. This varies from patient to patient though is usually between 1 - 4 days.

 

Failure to relieve pain and recurrent stenosis

Spinal stenosis surgery is sometimes a compromise between removing enough of the compressive bone and ligament to decompress the nerves adequately and preserving enough bone to maintain the stability of the spine. If too much is removed, back pain results. If too little is removed there may be persisting leg pain. This means that in an effort to prevent post operative back pain sometimes  there could be persisting compression of the nerves that may cause persisting leg symptoms and may need further surgery. The degenerative process also will continue after surgery and sometimes after some years the condition may recurr and need further surgery.

     

    Time off work

    If you are in sedentary work, or can return to light duties initially you should be able to manage part time work in three weeks. Everyone will be different and exactly how part time you are will depend on your progress. Most people should be at full duties in a sedentary or moderate level job by six weeks. If you are in a heavy job you will need to do some gymnasium work before the heavier parts of your job are recommenced at about 8 weeks post operatively.

    Success rate

    It is difficult to accurately define the succes rate of the procedure in general. Usually the success rate is high.