Your spinal cord needs adequate space inside the spinal canal. The spinal canal is a protective ring of bone that surrounds your spinal cord. Conditions such as fractures, dislocations, tumors, or degenerative changes in the discs and joints of your spine can put pressure on your spinal cord. This is because the protective ring of bone around your spinal cord does not expand to accommodate the need for more space. Extra pressure within the confined space of the spinal canal can place your entire spinal cord in danger. Surgery to open the back of your spinal canal is one way to relieve the pressure on your spinal cord. This procedure is called a laminectomy.
Bone spurs or a herniated disc can take up space inside your spinal canal and put pressure on your spinal cord. This condition is called spinal stenosis. If spinal stenosis is the main cause of your back pain, your spinal canal must be made larger. Any bone spurs pressing on the nerves must also be removed. One way this is done is with a complete laminectomy. Laminectomy means “remove the lamina.” Removing the lamina and any bone spurs gives more room for your nerves. A laminectomy reduces the pressure on your spinal nerves, thereby decreasing any irritation or inflammation. For this reason, laminectomy is often referred to as spinal decompression.
A laminectomy may be performed on the cervical spine (you neck) or the lumbar spine (your low back), depending on where your spinal problem is. Your doctor will begin by making an incision down the center of your spine over the vertebra or vertebrae where the laminectomy will be performed. Muscles are then moved to the side.
Upon reaching the back surface of your spine, your doctor will use an X-ray to identify the problem vertebra. The lamina is removed , taking the pressure off the back part of your spinal cord and nerves.
Removing the entire lamina may cause problems with the stability of your spine. If the facet joints are damaged during the laminectomy, your spine may become unstable and cause problems later. One way your doctor may try to prevent this problem is to not actually remove the lamina. Instead, the lamina may be cut on one side and folded back slightly. The other side of the lamina opens like a hinge. This makes your spinal canal larger, giving your spinal cord more room. The cut area of the lamina eventually heals to keep your spine from tilting forward.
If your doctor has to remove too much of the facet joints during a laminectomy, a spinal fusion may also be required at the same time to make sure there are no problems later. Your doctor will probably discuss this possibility with you before surgery.
You should be able to get up and begin moving a few hours after your laminectomy, and you should be able to return home when your medical condition is stabilized, usually within one to two days after surgery.