A laminectomy (the removal of the lamina which is the posterior part of the bony spinal canal) is performed when the spinal cord is compressed by bony narrowing and thickening of the spinal canal ligaments and/or bulging of the intervertebral discs.
The operation will be done through an incision on the back of your neck (approximately 5-25cm depending on how many levels need to be done). Once the muscles are reflected out of the way the lamina are exposed and can then be removed to relieve the pressure on the spinal cord and the nerve roots. Up to 7 lamina can be removed in the neck. Your surgeon will tell you how many he or she is planning to remove prior to surgery.
Your neck may be more painful for 8-12 weeks after surgery. The operation is not designed to relieve any neck pain you may be experiencing prior to surgery. The operation is designed to relieve the pressure on the spinal cord. This usually gives symptoms of numbness, weakness and clumsiness in the arms and legs.
There is a 50- 80% chance of improving your symptoms with the operation depending on the MR scan appearances. At the very least the operation will stop you from getting worse. Your surgeon will have given you more precise indication of the likelihood of relief in your particular case.
There is a less than 1% chance of leakage of spinal fluid after the operation. This may cause headaches or a leaking or bulging wound after surgery. The risk of wound infection is less that 2%. You will be given antibiotic with your anaesthetic to minimise this risk.
There is a risk of spinal cord and nerve damage from the operation. The risk of spinal cord damage is small (0.3 -1%). At worst it could lead to complete paralysis from the neck down including loss of bladder and bowel function. This is not common, but is a recognised risk of this type of surgery.
There is a small risk (2-3%) of slippage of the bones in the months and years after surgery. If this happens and causes more discomfort you may need further surgery. This can happen even without surgery, simply because of “wear and tear”. The risk of this happening is outweighed by the benefit to you from this type of surgery.
You will be in hospital for 2 days after surgery. You are allowed to walk, sit and lie down. It is best to vary your activity and to keep on the move as much as possible. The physiotherapists will give you more detailed instructions re exercises prior to discharge. You are advised not to drive for at least three weeks after surgery. You have to be safe to do an emergency stop and to be able to turn your head to see traffic before driving.
Most people do not need to wear a collar after this type of surgery but if you are very sore we may suggest you wear a collar for short periods eg. when in the car, simply for comfort.
