laminectomy

A laminectomy is a surgical procedure in which one or more laminae, the back part of a vertebra that forms the posterior wall of the spinal canal, are removed to relieve pressure on the spinal cord or nerve roots. It is usually performed from a posterior approach and may involve removing part of the spinous process. Laminectomy may be done on multiple levels and is often used to decompress the spinal canal in conditions such as spinal stenosis, herniated discs, tumors, or traumatic compression.

Indications include degenerative spinal stenosis with neurogenic claudication, foraminal stenosis causing radiculopathy, myelopathy from disc protrusion or tumors, and unstable fractures. In the cervical spine, the procedure carries greater risks to stability and movement; alternatives such as laminoplasty may be used in some cases. In the lumbar spine, laminectomy is a common decompression operation and may be combined with fusion if instability is present or anticipated.

Overview of the procedure: Under general anesthesia, the patient lies face down. A midline incision exposes the affected levels; muscles are reflected to reveal the laminae, which are removed with a drill and rongeurs to relieve pressure on the dura and nerve roots. Dural tears are possible. Additional decompression or tumor removal may be performed. If instability is a concern, posterior fusion with instrumentation may be added.

Recovery and outcomes: Hospital stays vary; rehabilitation begins soon after surgery. Many patients experience relief of leg or arm pain and improved function, though full recovery may take weeks to months and some symptoms persist. Risks include infection, bleeding, dural tears and CSF leaks, nerve injury, spinal instability, blood clots, and anesthesia risks. Long-term results depend on the underlying condition and the presence of additional spine pathology.