Laminectomy for the lower back or lumbar laminectomy refers to the surgical procedure used for different types of spinal stenosis. It is also often referred to as decompression surgery because the main goal here is to provide relief to the nerve roots under pressure.
Apart from lumbar laminectomy for spinal stenosis, this procedure is also used in cases of herniated disks, injury to the vertebrae, tumors, and other similar problems. This surgery is often recommended by doctors only if all types of non-surgical treatments have failed.
In this article, we will take a detailed look at the different causes of back pain, how they are treated by laminectomies, and whether if it is safe or not.
Main Goals of Laminectomy Surgeries
Lumbar laminectomy for spinal stenosis and other problems is done in order to return the patient to their daily lives without constant pain or weakness in the arms, legs, or lower back. Take a look at the following goals that you can expect to achieve after the surgery:
Better Leg Function
When the nerve roots around the spine get compressed due to complications in the vertebrae, some symptoms like weakness and shaking in legs and hands can show up. This is a result of the insatiability caused by the obstruction and can be treated by laminectomy in case therapy and steroids don’t work. In the case of laminectomy for spinal stenosis, the spinal canal is widened to relieve the pressure on the nerves.
Tackling Other Neurological Problems
The main goal of lumbar laminectomies is to relieve problems in the lower back and legs. But, it does not aim to surely treat chronic back pain problems associated with diseases like spinal stenosis.
However, once the pressure on the nerve roots is alleviated, many patients report feeling either much lesser pain, or not feeling it at all. The outcome of the surgery and the subsequent pain levels depend on factors like other pathological issues with the patient, level of degradation of the vertebrae, and age.
Also, if the root cause of spinal stenosis or other problems is Arthritis, then pain relief may not be possible as only the surgery aims to only treat complexities rising from the nerve roots under pressure, like shivering of the legs, bowel or bladder control, and general discomfort while walking.
Common Lower Back Problems Treated With Laminectomy
Spinal Stenosis
This problem mostly originates in people with osteoarthritis and is caused by general degradation of the spine. The spinal cavity narrows down gradually, leading to more pressure on the nerve roots inside the spinal cavity.
Laminectomy for spinal stenosis involves the removal of the lamina from the affected vertebra. In some cases, this surgery may need to be followed with an additional fusion surgery for the adjacent vertebra to keep the spinal structure stable.
Herniated Discs
The aging process and a few other factors can lead to the spinal discs wearing down over time. When this happens, and the disc can rupture, leading to their structures changing from soft and elastic to hard and flat. The affected discs then exert pressure on the surrounding nerves, leading to lower back pain.
This problem is often treated with a special type of laminectomy that allows the surgeon to remove the extra material that protrudes between the vertebrae. After the surgery, the pressure on the nerves is not present anymore, and hence the patient experiences relief from the symptoms.
Categories of Lumbar Laminectomy for Spinal Stenosis
Depending on a few varying factors, laminectomy for spinal stenosis can be divided into two categories – Bilateral and Unilateral. Let’s take a brief look at them.
- Bilateral Laminectomy
This refers to the process where both sides of the lamina are removed from the vertebra. It may also be accompanied by the removal of tissue adjacent to the affected nerves and widening the foramina present between the vertebrae.
- Unilateral Laminectomy
The surgery is done on only one side, and either the whole lamina or a part of it is removed from the pressure-exerting vertebrae. The adjacent tissues may or may not be removed, depending on the patient’s condition and other factors. This type of laminectomy also allows for minimally invasive surgeries, which are considered to be the better option by many surgeons.
How is the Laminectomy Surgery Performed?
To start off the surgery, the patient is first administered with general anesthesia. Next, a special device pads the front side of the body in order to keep it stable and supported. After this, an incision is made on the part that is being operated on.
The muscles and skin tissues are separated to access the spinal structure, where the surgeon can either cut off the entire lamina or a part of it to decompress the surrounding nerves. This process can also be done by minimally invasive surgery, which is possible in the case of unilateral laminectomy.
With these procedures, the healing time required by the scar tissue is much less, as a small incision is made without disturbing the skin. Next, the endoscope or a microscope along with x-ray imaging is used to navigate and complete the operation without putting extra stress on the patient’s body.
The surgery usually lasts for a couple of hours, with more time needed in case of complications and also depending on the type of laminectomy being performed.
Potential Risks of Laminectomy Surgery
There are a few risks that come with any type of surgery being performed on the body. As the laminectomy process uses general anesthesia, and access to delicate nerves, the risks can be potentially higher.
But, almost 70%-80% of people report relief from their symptoms after the surgery and are able to lead normal lives. The severe failure rate for this surgery is about 1%, because of the highly skilled surgeons and modern techniques.
Final Words
Back pain can be caused due to a variety of factors, with the most common being general degradation along with old age. Lower back pain can inhibit mobility in people and restrain them from doing their daily activities.
Most doctors recommend using the non-surgical methods first to try and alleviate the symptoms, but in case they don’t work, surgery is a good choice to get relief from the pain and weakness in the legs and the lower back region. Laminectomy is one of the most common surgeries used to treat this problem and allows patients to lead a fully active lifestyle without any major complications.
