One of the most common spine surgery in the lower back in which the laminae, the bony part of the vertebra that forms the roof of the spinal canal through which the spinal cord runs and spinal nerve roots emanate, are removed in order to relieve pressure being put on the spinal cord or the spinal nerve roots exiting from it. It is also referred to as Open decompression surgery.
The surgery can be carried out at a single vertebral level or multiple levels depending upon the number of vertebrae affected. The surgery may or may not be combined with another surgery such as spinal fusion or discectomy.
Q1 What are laminae?
A1 Laminae (Lamina;Singular) are the bony part of the vertebra that form the roof of the spinal canal and protect the spinal cord and the spinal nerve roots exiting from it. Each vertebra has two laminae and they join to form the roof of the spinal canal.
Q2 What is spinal canal?
A2 A long hollow tunnel or cavity formed at the back of the vertebral coloumn when the vertebrae are stacked one above the other. The spinal cord runs through this canal.
Q3 What is meant by Spinal stenosis?
A3 Spinal stenosis is a medical condition which is characterized by abnormal narrowing of the spinal canal resulting in the undue pressure on the spinal cord and spinal nerve roots exiting from it. It may occur at any level in the spine. When it happens in the neck area, it is better known as Cervical spinal stenosis. This is rare. If stenosis happens to be in the lower back or lumbar region, it is called Lumbar spinal stenosis. Nearly 75% of the spinal stenosis occur in the lower back or Lumbar vertebra. Spinal stenosis is considered as one of the most common reason for the spine surgery.
Q4 What are the causes of spinal stenosis?
A4 The causes of the spinal stenosis can be classified into two main groups:
Acquired causes can be further classified into:
Q5 How is Lumbar Laminectomy spine surgery carried out?
A5 Lumbar laminectomy may be advised by your surgeon in case of spinal stenosis(abnormal narrowing of the spinal canal) in the lower back area. It involves the surgical removal of the whole or part of the laminae(part of the vertebra) to widen the spinal canal and give more space to the spinal cord and the spinal nerve root resulting in the immediate alleviation of the symptoms associated with the compression of the spinal nerve roots and the spinal cord.
If a herniated disc is present, your surgeon may simulteneously perform discectomy to remove the source of the nerve compression right away. Laminectomy may be required in the neck region(cervical laminectomy) or lower back(Lumbar laminectomy) at a single vertebral or multiple vertebral level.
During Lumbar laminectomy, patient is made to lie on his/her stomach or side.A small incision is made over the affected area of the spine. Muscles are retracted back to the side to view the surgical site. Part or whole of the lamina is removed with the help of a bone drill;spinal canal seen and the source of the nerve compression like a herniated disc is removed.
Once done, the incision is closed with stitches.
Q6 What kind of anesthesia is required?
A6 Either general or spinal anesthesia may be given by your surgeon. Under general anesthesia patient would be asleep at the time of the surgery. Under spinal anesthesia, the patient would be awake during the surgery,however, the area where the surgeon would be working, would be made numb and there would be no sensation in the lower part of your body.
Q7 How much time does Lumbar laminectomy take?
A7 Lumbar Laminectomy usually takes around 1 to 3 hrs.
Q8 Who is an ideal candidate for the surgery?
A8 Anyone who has shown no relief in the symptoms even after 6 weeks of treatment with non surgical modalities such as pain medication, physiotherapy,epidural injection of steroids and an exact cause of the problem is elucidated through investigations such as MRI, then only the surgery can be considered as a viable option. The final decision whether surgery is the right option for you or not, lies with your team of specialists after evaluating your medical reports and your clinical examination.
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Mr Kwasi (Ghana)
08 Jan , 2017
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