Lumbar Laminectomy

A lumbar laminectomy is a surgical procedure that is performed to alleviate pain caused by neural impingement. The laminectomy surgery is designed to remove a portion of the bone over the nerve root and/or disc material from under the nerve root to give the nerve root more space and a better healing environment. A laminectomy can be effective to decrease pain and improve function for patients with lumbar spinal stenosis. Spinal stenosis is a condition that primarily afflicts elderly patients, and is caused by degenerative changes that result in enlargement of the facet joints. The enlarged joints then place pressure on the nerves, and this pressure may be effectively relieved with a lumbar laminectomy.

The lumbar laminectomy differs from a microdiscectomy or laminotomy in that the incision is longer and there is more muscle stripping.

First, the back is approached through a two-inch to five-inch long incision in the midline of the back and the back muscles are dissected off the lamina on both sides and at the effected levels.
After the spine is approached, the lamina is removed (laminectomy) which allows visualization of the nerve roots.
The facet joints, which are directly over the nerve roots, may then be undercut (trimmed) to give the nerve roots more room.

Post-operatively, patients are in the hospital for one to three days, and the individual patient's mobilization (return to normal activity) is largely dependent on his/her pre-operative condition and age. Directly following the procedure, patients are encouraged to walk. However, it is recommended that patients avoid excessive bending, lifting or twisting for six weeks in order to avoid pulling on the suture line before it heals.

Surgical results are much better for relief of leg pain caused by spinal stenosis, and not nearly as reliable for relief of lower back pain. Lumbar spinal stenosis is often created by the facet joints becoming arthritic, and much of the back pain is from the arthritis. Although removing the lamina and part of the facet joint can create more room for the nerve roots it does not eliminate the arthritis. Unfortunately, the symptoms may recur after several years as the degenerative process that originally produced the spinal stenosis continues.

In certain instances the success rate of a decompression for spinal stenosis can be enhanced by also fusing a joint. Fusing the joint prevents the spinal stenosis from recurring and can help eliminate pain from an unstable segment. Fusion surgery may be useful if there is a degenerative spondylolisthesis associated with the stenosis.

For more information, contact us at info@nhneurospine.com

As you read this information, keep in mind that all treatment and outcome results are specific to the individual. Only your physician can provide you with a detailed list of your specific indications, precautions, potential adverse events, and other important medical information.

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