Laminectomy / Discectomy

Laminectomy and microdiscectomy are surgical procedures used to relieve pressure on compressed nerves. A laminectomy relieves pressure by removing or trimming the lamina (the roof of the vertebra) to create more space for the nerves exiting the spine. It can also help relieve symptoms caused by spinal stenosis (narrowing of the spinal canal), which may result from degeneration of the facet joints and intervertebral discs.

A microdiscectomy uses a smaller skin incision to remove a herniated disc. In some cases, however, this approach may not be suitable due to the patient’s anatomy or medical condition. In these situations, a standard discectomy may be performed, which requires a larger incision.

Conditions Treated

As we age, gradual wear and tear can make the spinal discs more susceptible to rupture or tearing. Heavy lifting or even minor trauma may cause a disc to herniate. Most disc herniations occur in the lumbar spine and can cause significant pain in the buttocks, thigh, and calf. They may also result in numbness, tingling, or weakness. A laminectomy or microdiscectomy may be recommended to relieve pressure on pinched nerves and address sources of compression, such as bone spurs, disc fragments, and herniated discs.

Procedure

These procedures are performed under general anaesthesia with the patient positioned face down on the operating table.

During a laminectomy, the surgeon removes part or all of the lamina to relieve pressure on the affected nerves. Other sources of compression, such as bone spurs and disc fragments, may also be removed during the procedure.

During a microdiscectomy, the surgeon uses real-time X-ray imaging (fluoroscopy) to accurately visualise the spine and identify the herniated disc. A guide wire is inserted through the skin and muscles to the affected area. Dilators are then used to create a pathway to the disc, allowing a microscope and specialised surgical instruments to be inserted and used to remove the herniated disc material.

Recovery

Recovery varies between patients and procedures. As a general guide, recovery may include the following:

• One to three days in hospital
• No heavy lifting for the first few weeks, followed by gradually increasing lifting activities as advised
• Time off work to allow for recovery
• Returning to work on restricted duties for a period of time
• No driving for a period of time, as advised by your surgeon
• No swimming for 4 to 6 weeks
• Physiotherapy
• Pain medication
• Rehabilitation is generally not required for this type of surgery
• A back brace may occasionally be required, although this is uncommon
• Follow-up appointments with an Occupational Therapist may be necessary