I don't have personal experience with a laminectomy, but I know what it's like to deal with back problems in EMS and be faced with the decisions of whether or not to have back surgery. I badly herniated two discs in the military and when I got out, had the bright idea to give a career in EMS a try. My symptoms were pretty bad the whole time I worked ground EMS and immediately improved once I got off a ground ambulance and started weight training. Many years later I still have symptoms but they are very manageable with exercise and keeping my weight down and avoiding certain jarring, high-impact activities like running. My philosophy is as long as I can deal with it on my own, I always have surgery as an option, but once I have it done, I can't have it un-done. With a laminectomy, most people have at least some improvement in their symptoms, but for many the improvement is minimal and a few actually get worse.
I would, at a minimum, talk to at least two surgeons and PT's and try to get a realistic idea - given an honest assessment of your own fitness level and weight and motivation - of what you should expect your course to be with conservative therapy vs. with surgery, and how likely you are to ever be able to safely work in EMS again.
To be blunt: If you are young and have not yet invested much time in this field, I would look for something else to do, whether you decide to have surgery or not. EMS is inherently a back-unfriendly environment, and "unlimited overtime" at 1.5x BLS ambulance rates is not worth your health. You can find something else that you enjoy that pays in 40 hours what you'd need to work 60 hours as an EMT to make, and is a lot easier on your back. Good luck.
