Lumbar laminectomy is a surgical procedure performed to relieve pressure on the nerves in the lower back (lumbar spine). This pressure is usually caused by conditions such as spinal stenosis, herniated discs, bone spurs or cysts, which can cause symptoms such as pain, numbness, or weakness in the back, legs, or buttocks.

What Happens During a Lumbar Laminectomy

Preparation

You will be admitted to hospital on the day of surgery and will be required to fast prior to the procedure. The specific fasting time will be provided by your anaesthetist.

Anaesthesia: You’ll be given a general anaesthesia, so you’ll be asleep and won’t feel any pain during the surgery.

A urinary catheter may be inserted during the procedure if longer procedural time is anticipated. Antibiotics are also administered to reduce the risk of infection.

Positioning

You’ll be positioned face down on the operating table, with your abdomen supported to maintain the natural curve of your spine. This position helps A/Prof Buckland access the spine.

Incision

A/Prof Buckland makes a small incision in the middle of your lower back over the affected vertebrae.

The muscles and soft tissues around the spine are gently moved aside to access the vertebrae.

Removal of the Lamina

The lamina is the bone at the back of the vertebra that covers the spinal canal. A/Prof Buckland carefully removes this part of the bone using specialized instruments, and under high magnification microscope to optimize visibility and accuracy. In addition to removing the lamina, we remove the underlying ligament that has thickened (ligamentum flavum).

Removing the lamina and ligament creates more space in the spinal canal, relieving pressure on the spinal cord or nerves.

Additional Procedures (if needed)

In some cases, A/Prof Buckland may also remove or trim other structures such as bone spurs, part of a herniated disc, or cysts that are contributing to the nerve compression.

Closure

Once the decompression is complete, A/Prof Buckland closes the incision with sutures.

A small drainage tube may be placed temporarily to help drain any fluid that builds up in the surgical area.

Postoperative Care and Recovery

Hospital Stay: You typically stay in the hospital for 1 night and are discharged home.

Pain Management: Pain after the surgery is managed with medications. You may also experience some discomfort at the incision site. Leg pain has typically substantially improved when you wake up, and the incision pain typically needs medication for 1-2 weeks postoperatively.

Outpatient Rehabilitation: A/Prof Buckland recommends that you mobilise on the day of surgery and continue to do so thereafter. This reduces your risk of complications such as pneumonia, pressure sores, and blood clots. Physiotherapy may be recommended to help strengthen the muscles around your spine and improve your mobility and will typically coincide with your appointment with A/Prof Buckland at 2-weeks and 8-weeks postoperatively.

Activity Restrictions: You’ll need to avoid heavy lifting, bending, or twisting for around 8 weeks. A/Prof Buckland will give you specific guidelines on when you can return to normal activities.

Long-term Outlook: Most patients experience significant relief from their symptoms after a lumbar laminectomy, and most are feeling significant functional improvement by 8 weeks post-surgery. To learn more about A/Prof Buckland’s outcomes from lumbar decompression surgery, click here.

Risks and Complications

As with any surgery, there are risks associated with lumbar laminectomy, including:

• Infection
• Bleeding
• Blood clots
• Nerve damage
• Spinal fluid leak
• Failure to relieve symptoms or recurrence of symptoms

A/Prof Buckland will discuss these risks with you before the surgery and take steps to minimize them. A/Prof Buckland’s treating team will provide more written and verbal information regarding the recovery process to ensure you are guided through it appropriately.