Lumbar Laminectomy

Overview

Lumbar laminectomy is the most direct and definitive treatment for lumbar spinal stenosis causing neurogenic claudication — the progressive inability to walk more than short distances due to leg pain, heaviness, numbness, or weakness that improves with sitting or leaning forward. Dr. Basques removes the lamina (the bony roof of the spinal canal) and thickened ligament (ligamentum flavum) at the stenotic levels, instantly creating more space for the compressed nerve roots. Unlike fusion procedures, laminectomy alone preserves motion and may not require instrumentation if the spine is stable. It is one of the most studied procedures in spine surgery with decades of evidence supporting its effectiveness for appropriately selected patients. Dr. Basques performs laminectomy through a midline incision using microscopic visualization to ensure complete decompression while protecting the nerves.

How It Works

Under general anesthesia, the patient is positioned face-down. A midline incision (typically 3–8 cm depending on the number of levels) is made over the affected area. The paraspinal muscles are elevated to expose the laminae. Using a surgical microscope, Dr. Basques uses a high-speed burr to thin the lamina, then removes it with fine instruments, along with the thickened ligamentum flavum. The dural sac (the covering of the nerves) is visualized to confirm full decompression. The nerve roots are checked to ensure they are free and no longer compressed. Foraminotomies are performed as needed. If the facet joints are preserved (at least 50% remaining on each side), the spine remains stable. The incision is closed in layers. The procedure typically takes 60–120 minutes depending on the number of levels.

Benefits

Who Is a Candidate?

Ideal candidates have lumbar spinal stenosis (central canal stenosis) causing neurogenic claudication that has failed 3–6 months of non-surgical treatment. Neurogenic claudication is characterized by leg pain, heaviness, or weakness that comes on with walking and standing — and is relieved by sitting, bending forward, or leaning on a shopping cart. Candidates should NOT have significant spinal instability (spondylolisthesis, scoliosis) on flexion/extension X-rays, as decompression alone without fusion could worsen instability. Dr. Basques carefully evaluates each patient to ensure laminectomy alone is safe and appropriate.

Recovery & Aftercare

Most patients stay in the hospital for 1–2 days. Walking begins the day after surgery — and most patients immediately notice they can walk farther without leg symptoms. Light activities resume after 2 weeks. Return to desk work is typically 3–4 weeks. No heavy lifting or strenuous activity for 6–8 weeks. Physical therapy begins at 4–6 weeks for core strengthening. Dr. Basques provides detailed activity guidelines.

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