A lumbar laminectomy is also known as an open decompression and
typically performed to alleviate pain caused by neural impingement that can
result from lumbar spinal stenosis.
A condition that primarily
afflicts elderly patients, spinal stenosis 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 the laminectomy.
The lumbar laminectomy is designed to remove a small 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
The surgical results of a lumbar laminectomy are particularly
effective for leg pain (sciatica) caused
by spinal stenosis, which can be severe. Unfortunately laminectomy surgery is
not nearly as reliable for relief of lower back pain.
This is because lumbar stenosis
is often created by the facet joints becoming arthritic, and much of the low 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.
Laminectomy is performed under general anesthesia, in this the patient is usually positioned lying on the side or stomach. Then a small straight incision is made over the damaged vertebra. And then a retractor is used to spread apart the muscles and the fatty tissues covering the spine. When the laminae have been reached, the bony arch is cut in order to get to the ligamentum flavum (which is a band of yellow tissue attached to the vertebra that helps to support the spinal column). Thereby an opening is made in the ligamentum flavum to reach the spinal canal and then to the compressed nerve. At this point the cause of compression will be visible (that may be a herniated disk, tumour, fragmented disk etc) which is then rectified. This Surgery is completed in one to three hours.
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In a Minimally Invasive spine surgery the surgeon makes a few small incisions unlike the open surgery where a single large incision is made. Minimally Invasive spine surgery has
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Salient features of these hospitals are:
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