A lumbar laminectomy is a surgical procedure most often performed to treat leg pain related to herniated discs, spinal stenosis, and other related conditions.
Stenosis can occur as people age where the ligaments of the spine thicken and harden, discs bulge, bones and joints enlarge, and bone spurs or osteophytes form.
The goal of a laminectomy is to relieve pressure on the spinal cord or spinal nerve by widening the spinal canal. This is done by removing or trimming the lamina (roof) of the vertebrae to create more space for the nerves.
During this surgery it is also possible to fuse vertebrae or remove part of a disc if needed. Various devices (like screws or rods) can also be used to enhance the ability to obtain a solid fusion and support unstable areas of the spine.
How the Procedure is Done
The patient is usually positioned face down on the operating table. A small incision (usually about 3-4 inches) is made in the lower back.
Muscles and fatty tissue are carefully spread apart to expose the required area of the spine.
A cut is made in the one of the ligaments of the spine (ligamentum flavum) in order to view the compressed nerve in detail . Once the compressed nerve can be seen, the cause of compression can be identified. Most cases of spinal compression are caused by a herniated disc - however, other sources of pressure that can cause compression may include:
1 - A disc fragment (this will often cause more severe symptoms)
2 - An osteophyte or bone spur (a rough protrusion of bone)
3 - Protruding/degenerating discs
4 - Facet arthritis and/or cysts
5 - Tumors
The compressed nerve is then retracted and the source of the compression is removed. If necessary, spinal fusion can be preformed to help stabilize the spine.
This occurs when a lot of bone needs to be removed and/or when multiple levels are operated on.
Then the procedure is finished! The incision is closed either using absorbable sutures (stitches), which absorb on their own and do not need to be removed, or skin sutures, which will have to be removed a few days after the surgery.