Incision size depends on how many levels we do. For one level, it could be ~2 inches; for multiple, 3–5 inches potentially. We try to minimize it but also need enough exposure to work safely.

Regarding fusion: if you have evidence of instability (like a slipped vertebra or a lot of facet joint removal is needed), the surgeon might recommend doing a fusion with screws and rods to stabilize and prevent future issues. If your spine is stable and we can preserve enough of the facet joints, we often do not fuse. It’s case-by-case.

Without fusion, recovery is a bit quicker and you keep motion. Surgeons aim to avoid fusion if possible for isolated stenosis, especially in older patients, to reduce surgery magnitude. But if needed (for example, if you have a slip at L4–5 causing stenosis), then a fusion might be done concurrently.

We’ll review your imaging beforehand and discuss if fusion is on the table or not.

Many patients notice improvement immediately in certain aspects – e.g., they stand up the day after surgery and realize the heaviness or pain in the calves is much less. For others, it may be gradual as inflammation subsides.

Generally, within days to weeks, you should see significant changes: you can walk further without needing to sit, or numbness/tingling improves. If there was weakness, that might take weeks to months to recover strength, depending on nerve healing.

In cervical cases, sometimes improvements in dexterity and gait are noticed within weeks, but if damage was long-standing, some things might not reverse fully (the goal was to stop it from getting worse and hopefully regain some function).

Pain often gets better pretty fast – the classic leg pains of stenosis ease up. You will have surgical pain for a week or two, but that’s manageable and temporary. After that, you may feel just soreness if you overdo it.

Each patient is different, but by 6 weeks, we expect you to be doing a lot more than pre-surgery, with less pain.

Laminectomy is primarily aimed at nerve compression (leg symptoms for lumbar, etc.). It doesn’t directly address back pain caused by arthritis or disc degeneration. Some patients find their back feels better because they can be more active and the removal of bony pressure relieves some achiness.

But it’s possible to still have some back pain post-op, as the underlying arthritis is still there (we just removed bone to relieve nerves). We will work on managing any residual back pain with therapy, exercise, and possibly medications.

If your back pain was largely muscular due to limited mobility, it might improve when you walk more. But if it’s facet arthritis, you might still feel stiffness or ache. That’s where physical therapy and core strengthening later can help.

We set expectations that the goal is nerve pain relief and improved walking, not necessarily a cure-all for any back ache. However, improved function can indirectly reduce some back pain in the long run.

Initially, we usually advise caution for about 6 weeks: avoid heavy lifting, bending, or twisting your spine a lot. This allows muscles and tissues to heal. After that, you gradually resume normal activities, guided by how you feel and possibly therapy. We encourage staying active but using good body mechanics.

As for stenosis returning: the bone we removed is gone for good (it doesn’t regrow significantly). However, degenerative changes can continue – other levels might develop stenosis over time. Or if only a partial laminectomy was done at a certain level, more spurs could form later. But generally, the decompressed levels stay decompressed.

The aging process continues, so say 10 years down the road, another level could narrow and cause symptoms. If one segment is freed and adjacent segments were borderline, sometimes patients can develop new symptoms from those later. Also, if no fusion was done and later instability occurs, that could cause a need for further surgery in the future.

But in many cases, a laminectomy gives lasting relief for that level’s issue. We’ll monitor your spine health on follow-ups. Maintaining a healthy lifestyle (weight control, core strength) can slow degeneration. There’s no guarantee stenosis won’t affect other parts of your spine eventually, but we address issues as they arise.

Yes, likely after the initial healing period. In the hospital, you’ll get basic instruction on walking and gentle movements. Once your incision is healed and you’re 4–6 weeks out, we often prescribe outpatient physical therapy.

The focus will be on strengthening your core and back muscles, improving flexibility, and practicing safe movement patterns. Therapy can also help you rebuild endurance for walking and teach balance exercises if needed (especially for those who had gait issues before).

It’s not mandatory in every case; some patients do fine with just home exercises and a walking regimen. But many benefit from guided PT to speed recovery and address any muscle weakness that developed while you were limited pre-op.

We definitely encourage daily walking as the best exercise starting soon after surgery (with increasing distance as tolerated). Swimming (once the incision is healed) or water therapy is great too, down the line.

The goal is to get you back to normal activity, so PT is a tool to help achieve that and possibly reduce any persistent low back stiffness. We’ll tailor recommendations to your age, condition, and personal goals.