Laminectomy / Discectomy

Laminectomy and microdiscectomies are both procedures used to relieve pressure on compressed nerves. A laminectomy relieves the pressure on compressed nerves by removing or cutting the lamina (roof) of vertebral bones to provide space for the nerves exiting the spine. It can also relieve the symptoms of narrowed spinal canal (spinal stenosis) caused by degenerating facet joints and discs. A microdiscectomy uses a smaller skin incision to remove herniated discs. Sometimes this is not possible, due to the patients’ physical anatomy and medical condition and instead a discectomy is performed, which requires a longer incision.

Conditions Treated

As we age, gradual wear and tear causes our spinal discs to become more susceptible to rupturing or tearing. Any heavy lifting or minor trauma can cause disc herniation. Most disc herniation occurs in the lumbar spine, causing debilitating pain in the buttocks, thigh and calf areas. It can also create numbness and tingling or weakness. A laminectomy or microdiscectomy might be recommended for pinched nerves and to treat the sources of compression such as bone spurs, disc fragments and herniated discs.

Procedure

The procedures are performed under general anaesthesia while the patient rests on their stomach.

For laminectomy, the surgeon removes part or all of the lamina to relieve the compression. Other compression sources such as bone spurs and disc fragments are also removed during surgery.

In microdiscectomy, the surgeon uses live-action x-ray called fluoroscopy to accurately visualise the spine and locate the herniated disc. A guide wire is inserted through the skin and muscles to the problem area. Dilators are used to create a tunnel leading to the affected disc to allow a microscope and special surgical instruments to be inserted to treat the disc.

Recovery

Recovery differs between patients and surgeries. As a general guide recovery may include the following:

• One to three days in hospital
• No heavy lifting for the first few weeks or so (and graduated lifting restrictions thereafter)
• Some time off work in order to recover
• You may need to return to work on restricted duties for a period of time
• You may not be able to drive for a period of time
• No swimming for 4 to 6 weeks
• Physiotherapy
• Pain medication
• Rehabilitation is unusual for this type of surgery
• A back brace is sometimes required, but is unusual for this type of surgery
• You may need to meet with an Occupational Therapist