Lumbar Laminectomy Surgery also called open decompression, is a surgical procedure performed to treat the symptoms of central spinal stenosis or narrowing of the spinal canal. The surgery involves removal of all or part of the lamina (posterior part of the vertebra) to provide more space for the compressed spinal cord and/or nerve roots.
Lumbar laminectomy is typically considered after nonsurgical treatments such as physical therapy, medications, and/or epidural steroid injections have been tried for a period of 8 to 12 weeks without improvement.
Lumbar Laminectomy surgery aims to accomplish the following goals:
- Relieve neural tissue compression. Stenosis of the spinal canal in the lumbar region may cause compression of the spinal cord, thecal sac, spinal dura, and/or the cauda equina. When one or more of these structures are compressed, neurogenic claudication (leg pain while walking or bending the spine backward) may occur, typically affecting both legs. Laminectomy helps relieve the compression of these neural tissues by widening the spinal canal.
- Improve leg function. Lumbar stenosis often causes decreased mobility due to pain and weakness in one or both legs. Laminectomy helps decrease pressure on the nerves, reducing leg pain, and potentially improving weakness and functionality of the lower back and legs.
Types of Lumbar Laminectomy for Spinal Stenosis:
Depending on the amount of lamina removed or the technique used to relieve neural compression, a lumbar laminectomy can be of the following types:
- Bilateral laminectomy: Both sides of the lamina of the affected vertebra are removed with or without widening of the intervertebral foramina and/or removal of adjacent tissue and bone.
- Unilateral laminotomy: A part of or the entire lamina on one side of the affected vertebra is removed with or without adjacent tissues.
Unilateral laminotomy may also be performed by using an endoscope (a small tube), which is minimally invasive and requires a smaller incision compared to open surgery. While minimally invasive techniques may preserve more tissue and bone and reduce healing time, the overall success rates of open and minimally invasive decompression are usually the same.