What is a
Lumbar Decompression Laminectomy?
Lumbar Decompression Laminectomy is a procedure to alleviate pain which is a result of pinched nerves, also referred to as “neural impingement”. Lumbar Spinal Stenosis is often the cause, as it creates a narrowing of the spinal canal due to conditions like spondylolthesis, degenerative disc disease, bone spurs, arthritis, or bulging discs. During this minimally invasive surgery, a portion of the bone above the nerve root, or of the disc beneath the nerve root, is removed. This effectively gives the nerve more room, eliminates the painful pinching, and promotes healing.
The surgery is performed using fluroscopy to provide visual aid to the surgeon. An incision of about 1 inch is made, to one side of the center of the spine. Instruments called dialators are placed, in sequence, to split the muscle that covers the “lamina”. The lamina is a bony structure on each of the spinal vertebrae, which provides a roof for the spinal canal, protecting the back of the spinal cord. The lamina, however, can be the source of painful nerve compression in the instance of a degenerative spinal condition resulting in narrowing of the spinal canal.
A retractor is placed to hold the muscle tissue back, so the surgeon can view and have an open pathway to the spine. Special instruments, microscopes and lighting enable precision and accuracy while bone spurs and the lamina are removed; this process is referred to as lumbar laminectomy or lumbar decompression. After this portion of the surgery is completed, the other side of the lamina may also be removed, the ligament under the bone is removed, and the disc is examined for defects.
Advantages of Minimally Invasive Decompressive Laminectomy
With this procedure, both sides of the spinal canal are decompressed with only one, off-center, incision. This preserves ligaments, the contra-lateral facet joint, and the midline spine. The minimally invasive process also avoids destabilization of the spine which, in open surgery, often requires fusion.
Smaller incisions, reduced pain during recovery, less blood loss, and the ability to perform this surgery on patients well in to their 80s makes Minimally Invasive Decompressive Laminectomy preferable, whenever possible, to open back surgery.