The term laminectomy is derived from lumber (lower spine), lamina (part of the spinal canal's bony structure) and -ectomy (removal). The operation is performed to relieve pressure on one or more spinal nerve roots. This pressure, often called nerve root compression or a "pinched nerve", is what often causes back and leg pain.

Nerve root compression is caused by:

• Ruptured disc - Also called a protruded, slipped or herniated disc.
• Spondylosis - Deterioration or "wear and tear" of multiple discs with bony spur formation and degenerative disc.
• Scar tissue
• Combination of the above factors

Lumbar laminectomy surgery is performed with the patient lying on the abdomen or side after being put "to sleep" with general anesthesia. The surgeon reaches the lumbar spine through an incision in the lower back. After the muscles of the back are spread apart using a retractor to expose the lamina, a portion of one or more vertebra are removed in order to reach the compressed nerve root(s). Once the point where the nerve is being compressed is located, the source of the pressure is removed. That may involve either:

• Removing the ruptured portion of the disc
• Removing the bony spurs and bony overgrowth
• Removing the scar tissue.

The operation normally takes approximately 2 hours. The skin layer is closed with either steri-strips, sutures or skin clips that will be removed at a later date. A large dressing will be placed over the incision for protection.

What To Expect After Surgery

A plastic drain will be seen through the surgical dressing to remove any blood that accumulates in the surgical area. The drain will probably be removed on the second day after surgery. The dressing will also be changed and a smaller one applied.

An IV may remain in your arm for two to three days to administer antibiotics or other medications you may need. This helps prevent infection and gives you proper nourishment until you are eating and drinking comfortably. You will begin regular fluid and food intake under the direction and advice of your surgeon. You may be given a "pain pump" or PCA-patient controlled anesthesia pump for the first 1 to 2 days after surgery.

After the acute pain has diminished, usually the day after surgery, a physical therapist will help you begin standing and walking again. They will also show you the proper way to get in and out of bed, sit and stand, and sleep position.

Pain
It is normal to have pain after your operation. It will be most severe in the lower back area where the surgery was done. Residual leg pain is not unusual, this is caused by swelling of the previously compressed nerve as well as from surgery itself. There may be muscle spasms across the back and down the legs. Medication will be perscribed to help relieve the pain and /or spasms.

Constipation
Constipation is a significant side effect of the pain medication. Your doctor will order a laxative to relieve constipation. We also recommend a diet of whole grain cereals, fruit and fruit juices.

Activity
Initially, you are permitted to get out of bed following surgery with assistance from a nurse. Thereafter, you should be up walking as much as tolerated. The goal is to do more walking each day. Start with short trips and set a graduated pace so that each day more activity is accomplished. The easiest way for you to get out of bed is to raise the head of the bed as far as it will go, balance yourself in a sitting position, then stand with weight distributed on the skeletal frame, to avoid straining of back muscles. Avoid prolonged sitting. Initially, you should only sit for meals.

General Attitude
It is normal to feel physically and emotionally let down and tired the second and third day after surgery. This may be a natural reaction to the stress of surgery and the lingering effects of anesthesia. While this feeling is not uncommon, it must not be allowed to get in the way of your positive attitude that is essential for recovery to normal activity.

Discharge from the hospital
The hospital stay for a lumbar laminectomy is approximately 2-3 days. Your progress and comfort will determine this.

At home you may climb stairs from the start; but slowly, one step at a time. You should be active, walking as much as possible, but avoid being tired. Lie down to rest as needed. Avoid prolonged sitting. You may sit in a hardback wood chair for meals and short periods. (10-15 minutes three times a day).

Walking each day is excellent exercise. You should begin with short trips and increase your distance up to 4-5 miles daily. This will take no more than one hour per day. Avoid pulling, pushing or lifting. In the future, always protect your back when lifting or bending. Proper body mechanics involve using your knees and not your back during these activities.

Have a family member check the incision line daily at home. If increased redness, swelling or drainage occurs and/or you develop a fever, visit your doctor. Sexual relations are permissible within reason, but be sure not to strain your back. You may take short trips in the car after two weeks, but should avoid driving the car yourself for approximately three weeks.

Questions regarding your return to work are best discussed with your surgeon at the first postoperative checkup. The return date will depend on a number of factors, including the type of work you do, your particular problem and your postoperative condition.

You will have "good" days and "bad" days just as you did at the hospital.
Nights may be uncomfortable; use of a heating pad may be of benefit.

Special Instructions

Follow-up to remove staples will be scheduled for ten to fourteen days following surgery. Another follow-up to see progress will be scheduled four to six weeks following surgery. Other follow-ups which may continue for as long as a year after surgery, will be scheduled depending on progress.