Recovery After Lumbar Laminectomy (Open Decompression) for Spinal Stenosis

Recovery after an open laminectomy surgery typically depends on the fitness and level of activity prior to surgery. A course of physical therapy may be advised to improve pre-surgical activity level in order to encourage better recovery after surgery. It typically takes 4 to 6 weeks until normal function is established.¹National Health Services. Recovery (2018). [online] Available at: https://www.nhs.uk/conditions/lumbar-decompression-surgery/recovery/. [Accessed 15 May 2019].^,2MedlinePlus Medical Encyclopedia. Spine Surgery – discharge (2017). [online] Medlineplus.gov. Available at: https://medlineplus.gov/ency/patientinstructions/000313.htm. [Accessed 15 May 2019]. When fusion is also done, it may take longer to recover.

Several precautions and procedures are necessary to ensure safe and complete recovery.

Initial Care at the Hospital After Lumbar Laminectomy

A hospital stay of 1 to 4 days is typically required following a lumbar laminectomy surgery.¹National Health Services. Recovery (2018). [online] Available at: https://www.nhs.uk/conditions/lumbar-decompression-surgery/recovery/. [Accessed 15 May 2019]. During this period, the patient is monitored by the hospital staff for any complications. Typically, a physical therapist works with the patient during the hospital stay to help with a guided rehabilitation program.

See Rehabilitation After Spine Surgery

Once moved to a regular ward from the observation room, the following procedures are usually followed:

• Pain medications may be administered, mostly through an intravenous (IV) line. Oral pain-relieving medications will follow after a short course of IV medication.
• A liquid diet is initially offered until solid foods can be tolerated.
• Getting out of bed and sitting on a chair is encouraged to get the muscles moving and prevent complete immobilization.
• Once getting up and sitting is done comfortably, walking is encouraged. Walking enables strengthening the lower back and leg muscles and aids in surgical recovery.
• Once walking in the halls is practiced, stairs may be introduced.
• A back brace may be used to provide support and help with pain control.
• The incision is covered with gauze if any discharge is present. Later, the treated region is usually left open to dry and heal.

It is important to note that bending and/or twisting is usually not allowed for the initial few weeks after surgery. These activities may strain the incision and the treated segments of the spine. It may also cause the disc to re-herniate.

Following the hospital stay, the patient may need to go through additional guided therapies at a rehabilitation facility or may go home.

Recovery and Precautions at Home Following Lumbar Laminectomy

During the first few weeks or months at home, exercises and activity restrictions must be followed. The at-home exercises are usually provided by the treating physical therapist. A few at-home procedures post-surgery are:

• Pain management. Pain management includes the use of medications as well as limiting and modifying activities to prevent excessive pain. Medications may include:
  • Pain-relieving medications. Pain-relieving medication such as opioids may be given for a few weeks to manage post-surgical pain. These medications are advised to be used for short-term with gradual tapering of dosage to prevent addiction. It is important to note that nonsteroidal anti-inflammatory drugs (NSAIDs) are not advised after a laminectomy surgery because these may delay bone healing. ³Pountos I, Georgouli T, Calori GM, Giannoudis PV. Do Nonsteroidal Anti-Inflammatory Drugs Affect Bone Healing? A Critical Analysis. The Scientific World Journal. 2012;2012:1-14. doi:10.1100/2012/606404.
  • Stool-softeners. Stool-softeners may be required in the initial weeks after surgery to prevent constipation from stress, fear of pain, and medications (such as opioids). Stool softeners allow easy passage of bowels without excessive straining.

    See Preventing Constipation After Back Surgery

• Incision care. It is advised to avoid activities such as bathing, swimming, and hot-tubs until the incision site has completely healed. Proper care of the incision can prevent rupture of sutures, infection, or other complications. If suture removal is required, this may be done 1 to 2 weeks after surgery at the surgeon’s office. Absorbable sutures usually dissolve within a week.
• Physical therapy. It is necessary to continue with the physical therapy program and follow the prescribed exercises as instructed. Vigorous activities such as running or lifting heavy weights (typically over 5 pounds) are not advised.
• Activity modification. It is advised to modify daily activities to reduce the risk of injuring the treated segments of the spine. A grabber tool or reaching aid may be used to pick things up from the floor and/or a long-handled bath brush may be used to avoid bending while taking a shower.

  Watch: How to Prep Your Home for Spine Surgery Recovery Video

• Compression stockings. Compression stockings may be advised to prevent blood-clot formation and to improve blood circulation.

See Practical Advice for Recovering from Back Surgery

Unless suture/staple removal is required, a follow-up appointment may be scheduled 4 to 6 weeks after surgery. During this appointment, a medical provider checks the progress of incision and bone healing, blood test values, radiographs or other medical imaging of the treated segments, and the overall health of the patient.

Driving may be resumed after 2 weeks if there is overall health improvement and if the course of opioids has been completed. However, only short trips are advised for the first few days or weeks.²MedlinePlus Medical Encyclopedia. Spine Surgery – discharge (2017). [online] Medlineplus.gov. Available at: https://medlineplus.gov/ency/patientinstructions/000313.htm. [Accessed 15 May 2019].

Complete recovery may take 4 to 6 weeks or a few months after a lumbar laminectomy depending on the age and general health of the patient and the number of segments treated.²MedlinePlus Medical Encyclopedia. Spine Surgery – discharge (2017). [online] Medlineplus.gov. Available at: https://medlineplus.gov/ency/patientinstructions/000313.htm. [Accessed 15 May 2019]. It should be noted that an open laminectomy with or without fusion does not bring the spine back to its complete normal functioning and flexibility. A small degree of increased flexibility or stiffness is usually present and usually remains life-long.

Complications and risks following a lumbar surgery are rare, but any changes in the incision site, pain levels, or general health must be discussed with a medical provider as soon as possible.