A laminectomy is a surgical procedure to decrease pain for sufferers of lumbar spinal stenosis. Spinal stenosis is a complaint that generally afflicts older people. The pain is caused by degenerative changes that result in the facet joints becoming enlarged and placing pressure on nerves. The best way to treat this ailment is with a lumbar laminectomy.
Lumbar laminectomy means open decompression. This surgery removes a small part of the bone, called the lamina, just over the nerve root. It can also remove disc material from underneath the nerve root in order to give the root a better healing environment or more space.
The surgical procedure starts with an incision approximately two to five inches long (about 5-13 cm) made in the midline of the back. The left and right back muscles are then dissected off the lamina on both sides and at various levels. Removal of the lamina is then performed. This allows the nerve roots to be exposed. The final procedure in the surgery consists of undercutting the facet joints. The facet joints are directly over the nerve roots, so trimming them gives the roots more room.
Following the operation, patients usually remain in the hospital for one to three days. How fast the patient recovers mobility is usually dependent on how old the patient is and his or her general health condition before the operation. Patients are encouraged to be mobile directly after the surgery, but are advised to refrain from any heavy lifting or exercise for at least six weeks. This is to avoid any pulling on the suture line before it heals properly.
Another treatment that can enhance the results of the decompression of spinal stenosis is to fuse the joint. Fusing the joint prevents stenosis from recurring and can eliminate pain from an unstable segment. If stenosis occurs at one level from an unstable joint, then decompression surgery combined with fusion is a more reliable option.
Laminectomy surgery has a very high success rate. Approximately 80% of patients feel improvement in their daily lives. Most also notice a significant reduction in their level of discomfort and pain. The success of a laminectomy is much higher if the sufferer feels more pain in their legs. It is not as successful for the treatment of lower back pain.
As with all surgery, a laminectomy has potential risks and complications. There is a 1 in 1,000 chance of nerve root damage or bladder/bowel incontinence. Infections happen in about 1% of elective cases. If infection occurs, further surgery combined with antibiotics is necessary to rectify the situation. Although complications are very rare, the surgery is usually performed on elderly patients who are at an increased risk.