What is a Laminectomy?
A laminectomy (also called decompressive laminectomy or spinal decompression) is the surgical removal of the lamina — the posterior arch of the vertebra — to enlarge the spinal canal and relieve pressure on the compressed spinal cord or nerve roots. It is the most common surgery for lumbar spinal stenosis.
Modern laminectomy is performed using minimally invasive techniques — either through a tubular retractor or endoscopically — avoiding the large open incisions and muscle stripping of traditional surgery. The result is equivalent decompression with significantly less post-operative pain and faster recovery.
When is Laminectomy Recommended?
- Lumbar spinal stenosis causing significant neurogenic claudication (walking limitation)
- Cervical stenosis with myelopathy (cord compression)
- Severe radiculopathy not responding to conservative treatment or injections
- Progressive neurological weakness
- Cauda equina syndrome (emergency decompression)
Types of Laminectomy
- Lumbar Laminectomy — for lumbar stenosis; most common; relieves leg pain and claudication
- Cervical Laminectomy — with or without fusion; for cervical myelopathy
- Laminotomy — partial removal of lamina (less destabilising); preferred for single-level stenosis
- UBED (Unilateral Biportal Endoscopic Decompression) — two small portals; excellent visualisation; rapid recovery
The Procedure
Positioning & Access
Patient prone under general anaesthesia. Small incision(s) made over affected levels. Tubular retractor or endoscope docked.
Bone Decompression
Lamina, thickened ligamentum flavum, and any compressing osteophytes removed. Canal expanded. Nerve roots freed.
Fusion (if required)
If instability is present (spondylolisthesis), pedicle screws and interbody cage added to stabilise the decompressed segment.
Recovery
Mobilised same day. Discharged day 1–2. Physiotherapy in week 2. Return to light work 2–4 weeks.
Outcomes
Laminectomy for spinal stenosis has excellent outcomes: 80–90% of patients experience significant improvement in walking distance and leg pain. Best results when performed before severe neurological damage has occurred. Fusion laminectomy (when combined with TLIF/PLIF) provides more durable outcomes in patients with spondylolisthesis.