Lumbar laminectomy (PP code V2560 / V2562)
Patients with a disc prolapse or degenerative ‘wear and tear’ changes in the back may have either leg pain (sciatica) due to nerve root compression or worsening mobility due to cramp (claudication). This is due to the narrowing of the spinal canal (stenosis). Depending on the appearance of the scans and the severity of the symptoms it may be necessary to consider posterior back surgery to decompress the spinal cord or nerve roots. The results of surgery are generally good. For patients with sciatica, leg pain will usually improve after surgery. Patients with claudication also see significant improvement in their mobility and functional independence.
The risks of surgery include:
- spinal fluid leak
- DVT/PE (clots in legs / lungs)
- scar tissue
- recurrent symptoms
- accelerated degeneration
- nerve root injury
- pain, numbness
- weakness, paralysis
- incontinence, impotence
- general anaesthetic complications (heart attack, stroke)
The operation is carried out under a general anaesthetic and lasts approximately 60 minutes. It involves making a small linear incision down the middle of the back. Once the spinal cord / nerve roots have been decompressed the wound is usually closed using a cosmetically sensitive technique with dissolvable stitches. This usually means there are no clips to be removed, although sometimes clips are used.
After the operation the patient will have a drain in the wound for 12-24 hours, which is removed on the ward before discharge. Most patients will go home the next day and will be recovering at home for approximately 4-6 weeks. Following surgery the patient may notice some back pain and stiffness but this should settle with simple anti-inflammatory medication such as ibuprofen. Some patients will develop tingling in the legs after surgery due to swelling around the nerves at the site of the operation. This is temporary and will usually settle down after a few days.
Patients do not usually need to wear a back brace or support. Specialist spinal physiotherapists will advice each patient on a postoperative exercise regime, to encourage back movements. Further outpatient physiotherapy sessions will be offered, where indicated.