Laminectomy & Discectomy

What Is Laminectomy & Discectomy?

A laminectomy removes part or all of the lamina — the bony arch forming the back wall of the spinal canal — to relieve pressure on the spinal cord and nerve roots. A discectomy removes the portion of a herniated disc that is compressing a nerve. These procedures are often combined and can be performed through a standard incision or using a minimally invasive approach. No fusion hardware is used. The goal is nerve decompression — your spine retains its normal motion at the treated level.

Common Indications

• Lumbar spinal stenosis causing leg pain, weakness, or difficulty walking
• Herniated disc causing shooting pain, numbness, or weakness in the leg (sciatica)
• Nerve compression that has not responded to conservative care
• Progressive neurological deficit such as worsening foot drop

The SPORT trials (Weinstein et al., JAMA 2006) demonstrated significant benefits of surgical decompression over non-surgical management for disc herniation and stenosis. Minimally invasive techniques achieve equivalent outcomes to open surgery with reduced blood loss and shorter hospital stay (Goldstein et al., World J Orthop 2015).

Alternatives to Surgery

Surgery is one option for managing your condition. Not all alternatives are appropriate for every patient — their suitability depends on your specific diagnosis, symptoms, and prior treatment history.

• Continued conservative management — physical therapy, chiropractic care, activity modification
• Epidural steroid injections for nerve pain and inflammation
• Selective nerve root blocks for radicular symptoms
• Oral medications — anti-inflammatory agents, neuropathic pain medications
• Observation — many disc herniations improve naturally over 6–12 weeks without surgery
• No surgery — with understanding that neurological deficit, if present, may persist without decompression

Choosing not to have surgery is always an option. Your surgeon has discussed what you can expect if you decide not to proceed, including the possibility that symptoms may persist, worsen, or in some cases improve without surgery.

What Happens During Surgery

Performed under general anesthesia · Typically 1–2 hours · Approach (open or minimally invasive) selected based on your anatomy

1. You are positioned face-down on the operating table.
2. An incision is made over the target spinal level. The approach may be standard open or minimally invasive depending on your anatomy and the extent of decompression required.
3. Muscles are carefully moved aside to expose the spine. A surgical microscope or loupe magnification is used for precision.
4. The lamina or a portion of it is removed to open the spinal canal and expose the compressed nerve.
5. If a disc herniation is present, the herniated fragment is removed (discectomy) to relieve nerve compression.
6. The nerve root is inspected to confirm it is fully decompressed and freely mobile.
7. The wound is closed in layers. No screws, rods, or cages are used — this is a decompression-only procedure.

Risks of Surgery

General Surgical Risks

• Infection — superficial or deep wound, epidural abscess, meningitis
• Bleeding or blood transfusion
• Blood clots (DVT or pulmonary embolism)
• Stroke
• Heart attack
• Paralysis
• Loss of bowel, bladder, or sexual function
• Death
• Adverse anesthesia reaction
• Urinary retention or urinary tract infection
• Vascular or abdominal injury
• Corneal abrasion or blindness
• Ulnar nerve, median nerve, or brachial plexus injury

Procedure-Specific Risks

• Dural tear with spinal fluid leak (~3–5% of cases)
• Nerve root injury — sensory changes, weakness, or paralysis (temporary or permanent)
• Recurrent disc herniation (5–15% over 5 years)
• Wrong level
• Bone fracture
• Spinal instability requiring a later fusion
• Epidural fibrosis (scar tissue) causing persistent symptoms
• Symptoms may be unchanged, worse, different, or new after surgery
• Additional surgery for any noted or unforeseen complications

Your Hospital Stay

Most patients are same-day surgery and go home the day of the procedure. An overnight stay is occasionally needed for observation or pain management. You will be asked to stand and walk before leaving. A responsible adult must drive you home.

Recovery at Home

Recurrent Disc Herniation

If your original leg symptoms return — especially shooting pain — contact our office. Recurrent disc herniation occurs in 5–15% of patients over 5 years after discectomy. Many recurrences are managed non-surgically.

Return to Work — Typical Timelines

All timelines are estimates. Your surgeon will provide formal work release at follow-up based on your progress.

Wound Care

• Keep the incision clean and dry for the first 48–72 hours after discharge.
• You may shower after 48 hours — allow water to run gently over the area. Do not scrub.
• Do not submerge in a bathtub, pool, or hot tub until cleared by your surgeon (typically 4–6 weeks).
• Steri-strips should fall off on their own over 7–10 days. Do not remove them.
• Dissolvable sutures do not need removal. External sutures or staples are removed at your 2-week visit.
• Monitor for signs of infection and call our office promptly if you have concerns.

Medications at Discharge

• Opioid pain medication — Use only as needed for pain not controlled by other measures. Do not drive, operate machinery, or consume alcohol while taking opioids. Short-term use only (1–2 weeks typical).
• Muscle relaxer — Helps reduce painful muscle spasm. May cause drowsiness.
• Stool softener (docusate) — Take while using opioids to prevent constipation. Drink 6–8 glasses of water daily.
• Acetaminophen (Tylenol) — Do not exceed 3,000 mg/day. Do not take additional Tylenol-containing products concurrently.

Opioids are for short-term use only — typically 1–2 weeks. Taper as pain allows. Do not request early refills. Dispose of unused medication safely at a pharmacy take-back program.

Follow-Up Schedule

Warning Signs

For urgent concerns outside of office hours, call (405) 748-3300 — our answering service is available 24 hours a day, 7 days a week.