Lumbar laminectomy is an operation to relieve pressure on the spinal nerves by removing the lamina (bony arch) and thickened ligamentum flavum at one or more levels. It is performed for lumbar spinal stenosis causing leg pain, numbness, and difficulty walking.
A midline incision is made over the affected levels. The muscles are retracted. The lamina and thickened ligament are removed to widen the spinal canal and free the compressed nerves. Multiple levels (typically two to four) may be decompressed. Minimally invasive techniques using tubular retractors may be used for single-level decompression. The operation takes one to two hours depending on the number of levels.
Laminectomy is recommended for symptomatic lumbar spinal stenosis causing neurogenic claudication (leg pain and heaviness with walking) that has not responded to physiotherapy, epidural injections, and activity modification.
Physiotherapy, epidural steroid injections, neuropathic pain medication, activity modification, and use of a walking frame or shopping trolley (leaning forward opens the spinal canal and reduces symptoms).
MRI confirming stenosis. Standard pre-assessment. Many patients are elderly with medical comorbidities requiring optimisation.
Improvement in walking distance and leg symptoms in approximately 70–80% of patients. Back pain is less reliably improved. Symptoms may recur over time as degeneration continues.
Pre-existing back pain may not improve with decompression alone.
Degenerative changes may cause new stenosis at adjacent levels over time.
Pre-existing numbness may not fully recover, particularly if long-standing.
Risk approximately 5-10%, higher in multi-level surgery and revision cases.
Risk approximately 1%.
Removing bone at multiple levels may cause the spine to become unstable, potentially requiring fusion.
Wound or deep infection.
Blood collection compressing nerves. Rare but requires urgent surgery.
Very rare.
General anaesthesia. Positioned prone. Careful attention to medical comorbidities in elderly patients.
Hospital stay one to three days. Walking encouraged immediately — most patients notice improved walking distance quickly. Return to light activities at two to four weeks. Driving at two to four weeks. Core strengthening programme from six weeks. Full recovery three to six months.
Review at six weeks. Further follow-up as needed.
Laminectomy reliably improves leg symptoms (claudication) but is less effective for isolated back pain. If back pain is the dominant problem, fusion may be considered.
Not usually for standard laminectomy. Fusion is added if there is pre-existing instability (spondylolisthesis) or if the decompression creates instability.
New stenosis can develop at adjacent levels over time as degeneration continues. The original levels may also re-stenose if scar tissue or further disc degeneration occurs.