The procedure known as a Lumbar Laminectomy, more commonly known as a Decompression Laminectomy, is a type of surgery performed on the spine in order to provide pain relief and reduce problematic levels of pressure on the spinal nerves that run along the lumbar section of the spine.
The procedure gets its name from the Latin words that signify “removal of the Lamina”. The Lamina is an important structural component of all vertebrae that forms part of the vertebral arch. By removing the vertebral laminae, the surgeon creates additional space within the vertebral cavity and thus reduces the internal pressure.
Signs Of A Spine Injury
One of the main conditions that requires a Lumbar Laminectomy is Spinal Stenosis. The most significant characteristic of Lumbar Stenosis is the abnormal narrowing of the spinal canal, or neural foramen, through which the spinal cord passes. Stenosis of the spine can be caused by various factors, the most common of which is an arthritic disease.
Arthritic diseases of the spine generally cause significant physical changes to the facet joints and vertebral discs which, in turn, begin to exert unnatural pressure upon the spinal cord and its associated nerve roots.
The most prevalent symptoms of Lumbar Stenosis, and most all spine injuries, include pervasive back pain, as well as numbness and weakness of the extremities. In the more severe cases, patients may experience incontinence and sexual dysfunction as well.
The Lumbar Laminectomy Procedure
The procedure for a Lumbar Laminectomy is rather straightforward. As with all major spinal surgeries, the patient is put under the effects of general anesthesia and securely placed on the operating table. An incision is made either from the front or the back depending on the location of the compressed vertebra as well as the alignment of the spine. Through this incision, the surgeon gains access to the desired vertebra and proceeds to remove the damage lamina and give the spinal cord and nerve roots additional space. An interlaminar implant may be inserted to ensure proper alignment of the spine during recovery.
Spine Surgery Recovery
The recovery period following a lumbar laminectomy procedure relatively short compared to other types of major spinal surgery. Most patients report experiencing significant and immediate relief from most symptoms, although a small percentage of patients will only experience slight relief over the initial post-operative weeks.
Patients will remain hospitalized for a short period while they are monitored for any possible post-op complications. Physical therapy is almost always recommended to hasten recovery and help patients regain full mobility and flexibility as quickly as possible.
Complications of Lumbar Laminectomy
The most common complications associated with a Lumbar Laminectomy surgery include bacterial and viral infections, nerve and vascular damage, thrombosis, hemorrhage, and spinal fluid leakage.
While spine surgeries are extremely sensitive procedures, medical advancements continue to make these operations safer, more effective and more efficient to reduce the risks associated with a Lumbar Laminectomy surgery.
Another type of laminectomy surgery is Cervical Laminectomy. Laminectomy of the cervical spine is especially useful in treating conditions that affect the cervical vertebrae of the neck. Just as the lumbar type of laminectomy surgery, the cervical laminectomy can be used to treat the symptoms of spinal stenosis.
During the cervical laminectomy, the lamina of a damaged or diseased vertebral disc is removed to relieve the pressure being exerted upon the spinal cord and associated nerve roots.
Signs Of Cervical Spine Injury
Spinal stenosis, or the abnormal narrowing of the vertebral canal through which the spinal cord passes, is the most common condition for which laminectomies are utilized. This narrowing is mostly due to arthritic degeneration of the spinal discs and the subsequent alteration of the intervertebral spaces. Another common side effect of arthritic diseases known to exacerbate the symptom of spinal stenosis is the accumulation of bony growths, or bone spurs, along the length of the spinal canal.
The most common symptoms of cervical spinal stenosis are, pervasive neck pain and a sensation of tingling and numbness along the shoulders which is known to spread out to the arms and hands. These symptoms are caused by abnormal pressure being exerted upon the spinal cord and cervical nerves. A cervical laminectomy aims to relieve this unnatural pressure through the precise removal of part of the bony structures of the cervical discs, or vertebrae.
Your doctor will determine if a laminectomy is the optimal course of action after evaluating your particular medical history and running a number of physical and digital imaging tests. These tests include X-Rays, CT scans, and MRIs. Because all surgery implies a degree of risk, your doctor will only recommend a laminectomy procedure if non-surgical treatment options fail to provide meaningful relief of your symptoms.
The procedure for a Cervical Laminectomy is relatively simple and will closely reflect the lumbar variant of the surgery. As with all major spinal surgery, the patient must undergo general anesthesia. A precise incision will be made along the base of your neck from the back. Through this incision, the surgical team gains access to the cervical vertebrae, or neck bones, and all associated musculature and ligaments.
Working carefully to avoid damage to the soft tissues of your neck, the surgeon removes a small section, known as the lamina, from the bony arches of the cervical disc. Once removed, the spinal cord and its associated nerves have a bit more space in which to rest, immediately reducing the pressure being exerted upon cervical spine. Any additional abnormalities that could impinge upon the spinal cord are cut away and removed. The wound is then cleaned, soft tissues are realigned, and the incision is sutured shut.
Custom meshes, plates, pins and screws can be inserted as needed to assist in supporting proper spine alignment and structural integrity.
Cervical Laminectomy Recovery
After the surgery, the first step towards a full recovery is starting a rehabilitative physical therapy plan. Physical therapy should only be attempted under the careful guidance of a physical therapist, especially after such a delicate procedure like a spinal operation.
Most patients that undergo spinal laminectomies experience immediate relief from most symptoms, and for the most part, hospital stays are minimal. However, some patients are hospitalized for a few days for close monitoring, especially if they are at risk of post-operative complications.
A full return to normal function will depend on the success of the physical therapy and your overall state of fitness going into the surgery, but most patients are fully healed in a matter of months.
Follow all doctor instructions as you recover from your spine surgery. Your surgical team, primary doctor and physical therapist will be able to set a proper timeline for resuming normal activities such as jogging, housework and professional work.
Risks & Complications
All surgeries carry a certain degree of risk. However, laminectomies are relatively safe with only a small chance of post-operative complications. That being said, since this is a spine surgery, complications can be severe. The most prominent risks associated with laminectomy procedures are an infection, nerve damage, and hemorrhage.