Decompressive Lumbar Laminectomy
What is it?
A Decompressive Lumbar Laminectomy is a decompression performed by removing the lamina and the spinous process.
Why is it done?
A decompressive lumbar laminectomy is usually recommended only when specific conditions are met. In general, surgery is recommended when a spinal nerve root(s) is pinched and you have:
- Leg pain which limits your normal daily activities
- Weakness in your leg(s) or feet
- Numbness in your legs
- Difficulty in walking or standing
The Operation
Incision
In the operating room, a decompressive lumbar laminectomy begins with an incision in your lower back. Through this opening, your surgeon will reach the area where your cauda equina and/or spinal nerve(s) are being pinched.
Reaching the Pinched Nerve
After the incision is made, the surgeon will use a retractor to pull aside fat and muscle until the vertebra is exposed. A fine drill is then used to remove a section of the vertebra. Next, an opening is cut in the ligamentum flavum through which the spinal canal can be reached.
Removing the Cause of Pressure
Once the spinal nerve root(s) and cauda equina have been exposed, the surgeon will use a fine drill to remove bone spurs or rough edges of the intervertebral disc . This will make the openings of the foramen and the spinal canal larger and help to relieve pressure on your spinal nerves.
Fusion And Instrumentation
On some occasions it may be necessary to stop the movement between two adjacent vertebrae. This is called a fusion. Your surgeon will place bone graft chips between the vertebrae to create a solid section of bone which prevents the motion. The surgeon may also elect to use metal implants to prevent any motion while the bone graft heals.
Closing the Incision
The operation is completed when each layer of the incision is closed with suture material (stitches) or surgical staples. If the outer incision is closed with staples or non-absorbable sutures, they will have to be removed after the incision has healed.