Laminectomy in Turkey

A laminectomy removes the lamina, the bony arch at the back of a vertebra, to make room for nerves that are being squeezed inside the spinal canal. It is the standard operation for lumbar spinal stenosis, the narrowing that makes your legs ache, burn or give way after walking a short distance.

It is decompression, not repair. That distinction decides whether the operation is likely to help you: laminectomy is far more reliable for leg symptoms than for back pain, and a surgeon who does not make that clear has skipped the most important sentence of the consultation.

• Laminectomy

  Removes the lamina across one or more levels to widen the canal. Used when the narrowing is central and involves several structures.

• Laminotomy

  Removes only part of the lamina, often on one side, keeping more bone and more of the spine's own stability. Suitable when the narrowing is more limited.

• Microdiscectomy

  Removes the part of a disc that is pressing on a single nerve root. It answers sciatica from a disc herniation rather than canal narrowing from bone and ligament.

• Decompression with fusion

  Adding fusion is a much bigger operation, used when the spine is unstable or a vertebra has slipped. It changes the recovery, the implants and the price, so it has to be settled before you travel.

If your symptoms come from a disc pressing on one nerve rather than from canal narrowing, the microdiscectomy page describes that operation. Neck symptoms are a different problem again and are covered on the cervical disc disease page, and curvature on the scoliosis treatment page.

1. 1

   Assessment and imaging

   Examination, walking tolerance, and an MRI that matches your symptoms to the level. Imaging findings without matching symptoms are not a reason to operate.
2. 2

   General anaesthetic and positioning

   You lie face down. Anaesthetic risk is assessed beforehand, which matters more with age and with heart or lung conditions.
3. 3

   The decompression

   The surgeon removes the lamina and any thickened ligament pressing on the nerves, widening the canal at the affected levels. Only what is needed is removed, because taking more bone than necessary can destabilise the spine.
4. 4

   Fusion, only if planned

   If instability or a slipped vertebra is present, screws and rods may be added. This should never be a surprise decision made while you are asleep.
5. 5

   Waking up and standing

   Getting up and walking early is part of the treatment, not a test of toughness. Most people are helped to their feet the same day or the next.
6. 6

   Hospital and discharge

   Several days in hospital is usual, longer if fusion was performed. Ask what your plan is before you agree to a date.

• How many levels. Decompressing several levels is a longer operation than one.
• Fusion or decompression alone. This is the single biggest difference in the quote, because of implants and theatre time.
• Implants and neuromonitoring. Screws, rods, cages and intraoperative nerve monitoring all add to the total and should be listed.
• Hospital days and rehabilitation. Spinal surgery is an inpatient operation, and the length of stay is part of the cost.
• What the package covers. Imaging, nights, transfers, medication, follow-up, and what happens if you need to stay longer.

The clinic list on this page shows each clinic's current price with a note on what it includes. For instalments, see payment plans. If a disc herniation rather than stenosis is the problem, see microdiscectomy, and for neck-related nerve pain see cervical disc disease.

• Ask whether a spine surgeon or a general neurosurgeon operates. And how many decompressions of your type they do.
• Ask how they decide between decompression and fusion. There should be criteria, not a preference.
• Ask what their rate of dural tear is and how they handle it. A surgeon who says it never happens is not counting.
• Ask what happens if the pain does not improve. Continuing pain after correct surgery is a known outcome, and how a clinic answers this tells you a great deal.
• Ask for the rehabilitation plan in writing. Including what you should be doing in the weeks after you get home.