The spine contains a complex system of nerves, including the spinal cord. The spinal nerves accept and interpret messages from nerves found throughout the body, including in the skin, bones, and organs. Unfortunately, if one of the spinal nerves becomes compressed, it can lead to chronic back pain, as well as numbness, weakness, and tingling in the extremities.
Spinal disorders that cause nerve compression may require surgery for long-term pain relief. Lumbar laminectomy is a surgical procedure that’s commonly performed for compressed nerves in the lumbar spine.
Here, we’ll discuss what patients with symptoms of spinal nerve compression should consider about the lumbar laminectomy procedure.
What’s Involved in Lumbar Laminectomy?
Lumbar laminectomy is a form of spinal decompression surgery. It involves removing some or all of the lamina, which is a section of bone that acts as the back of the spinal canal.
By removing the lamina, the surgeon creates more room for the spinal nerves. This alleviates compression, reduces irritation, and provides a long-term solution for symptoms of spinal disorders including:
- Spinal stenosis, which involves the narrowing of the spinal canal
- Herniated disc, which occurs when the interior of a spinal disc protrudes through a crack in the disc exterior
- Bone spurs, which are lumps of excess bone that develop as a result of osteoarthritis and may take up space in the spinal canal
What’s The Difference Between Laminectomy and Laminotomy?
Laminectomy is commonly confused with laminotomy, and vice versa. These forms of spinal decompression surgery are very similar, but have a key distinction.
In laminotomy, the spinal surgeon only removes a small portion of the lamina. This procedure is typically used to address disc herniation.
A larger portion of the lamina, or the entire lamina, is removed during laminectomy. This procedure is widely done to treat spinal stenosis and other disorders involving the spinal canal.
Your spinal specialist will consider your unique needs to determine whether laminotomy or laminectomy is right for you.
What Are The Steps of a Lumbar Laminectomy?
A lumbar laminectomy is typically performed with the patient under general anesthesia. Once the patient is asleep, the spinal surgeon will carry out these steps:
- The surgeon will create an incision positioned over the affected vertebra(e).
- To gain access to the vertebra(e), the surgeon will move the muscles aside.
- The surgeon will remove some or all of the lamina, as well as bone spurs and all or part of a damaged disc, if needed.
- The surgeon will close the incision.
Additionally, spinal specialists often complete spinal fusion at the same time as a lumbar laminectomy.
Lumbar Laminectomy With Spinal Fusion
Spinal fusion is a surgical procedure that involves integrating two vertebrae into one bone using bone graft material. This technique can prevent further injury after laminectomy by stabilizing the spine.
If spinal fusion is performed with a lumbar laminectomy, the spinal surgeon will place bone graft material in between the affected vertebrae. The bone graft material may be synthetic or taken from your own body (typically the spine or pelvis).
As time passes after spinal fusion, the bone graft material will cause the affected vertebrae to combine into one bone. This process eliminates motion at the affected segment.
What Are The Risks of Lumbar Laminectomy?
Lumbar laminectomy is a surgical procedure. So, as with any form of surgery, it comes with a risk of complications, such as:
- Blood clots
- Injury to the spinal cord or nerve roots
- Complications associated with general anesthesia
With that in mind, lumbar laminectomy is a common procedure that’s widely regarded as safe and effective for patients with spinal disorders like spinal stenosis.
Spinal fusion is associated with additional risks and downsides. For one, spinal fusion may significantly limit patients’ back mobility. The patient won’t be able to twist, bend, or flex the spine at the fused segment, which may eliminate their ability to participate in certain activities. After fusion, some patients need a special tool to pick up items off of the floor.
Additionally, adjacent segment disease, or ASD, is a complication associated with spinal fusion. This condition occurs when the segments above and below the fused segment undergo added stress. As a result, the adjacent segments degenerate more rapidly than usual, often leading to back pain and neurological symptoms.
What’s The Recovery Process Like For Lumbar Laminectomy?
The recovery process for lumbar laminectomy depends on whether or not you also underwent spinal fusion. With a non-fusion decompressive laminectomy, patients can typically return to non-strenuous activity within a few days to a few weeks. However, the laminectomy recovery with fusion is much longer.
After a lumbar laminectomy with spinal fusion, patients generally need four to six weeks before going back to work, and even longer before engaging in physical activity. It can take patients up to a year to fully recover from laminectomy with fusion. Additionally, patients are often advised to remain in the hospital for up to four days after the spinal fusion procedure.
Whether you undergo laminectomy with or without spinal fusion, your physician will likely recommend that you follow a program of physical therapy throughout your recovery process. Physical therapy after laminectomy involves exercises to strengthen the muscles that support the spine, improve spinal alignment, and alleviate tension.
Are There Alternatives To Spinal Fusion For Laminectomy Patients?
Considering the limited mobility, extensive recovery process, and complications associated with spinal fusion, many laminectomy patients seek out other options. Non-fusion spinal implants are spinal fusion alternatives that can restore stability after a lumbar laminectomy without the risks and downsides of fusion.
Non-fusion implants that preserve the motion of the spine are becoming more widely used for spinal disorders. Patients who have been recommended to undergo lumbar laminectomy should consider learning more about these innovative fusion alternatives.