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Lumbar Laminectomy

ID: ANCE00191
MEDICAL ANIMATION TRANSCRIPT: Laminectomy is the surgical removal of part of the vertebral bone called the lamina. Twenty-four vertebrae make up the vertebral column or spinal column. Each vertebra has two laminae fused together to form the roof of the spinal canal. The laminae protect the spinal cord in the neck and back regions. In the lower back, where the spinal cord ends, the laminae protect the large bundle of nerve roots called the cauda equina, as well as the nerve roots exiting the spine. Nerve root compression can be caused by bony spurs from arthritis, a herniated disc compressing the nerve root, or, less commonly, a bony tumor of the vertebra. A laminectomy relieves back and leg pain caused by this nerve root compression by removing all or part of the lamina. This immediately alleviates the pressure on the nerve root. If a herniated disc is present, your doctor will often perform a discectomy, which directly removes the source of the compression. A laminectomy can be done on a vertebra in the lower back called the lumbar vertebrae or those in the neck region called cervical vertebrae. Microlaminectomy and microdiscectomy are procedures performed with the aid of a microscope. When you arrive at the hospital, an intravenous line will be started, and a catheter may be placed in your bladder to drain your urine. Just before surgery, you will be given either general or spinal anesthesia. Spinal anesthesia is injected into a sac that surrounds your spinal cord and numbs the area where the doctor will be working. With spinal anesthesia, you will be awake during the procedure, but you have no feeling in the lower half of your body. A laminectomy takes about one to three hours. You will lie on your stomach or on your side for the duration of the procedure. Your surgeon will begin by making a small incision overlying your spine. Retractors are used to pull fat and muscles away from the lamina. Using a special bone drill, your surgeon will cut away the lamina in order to see into the spinal canal and locate the source of the nerve compression. If a herniated disk is causing the compression, he or she will perform a discectomy by removing the protruding part of the disk. To complete the procedure, the deep tissues and incision in your back will be closed with stitches. After your surgery, you'll be taken to the recovery room for monitoring. The nursing staff will regularly check vital signs and the strength of the leg on the side of your surgery to be sure the nerve has not been severely injured. You will be encouraged to get up and walk as soon as you feel comfortable. If a catheter was inserted before your surgery, it will be removed before you leave the hospital. If you've had an uncomplicated discectomy, you will likely leave the hospital the next day. Laminectomies performed for other reasons may require longer hospital stays.

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