Also known as an open decompression, a lumbar laminectomy is typically performed to alleviate pain caused by neural impingement that can result from lumbar spinal stenosis.
A condition that primarily afflicts elderly patients, spinal stenosis is caused by degenerative changes that result in enlargement of the facet joints. The enlarged joints then place pressure on the nerves. This pressure may be effectively relieved with the laminectomy. The lumbar laminectomy is designed to remove a small portion of the bone over the nerve root to give it more space and a better healing environment. The lumbar laminectomy differs from a microdiscectomy in that the incision is longer and there is more muscle stripping.
First, the back is approached through a two to five-inch long incision in the midline of the back, and the left and right back muscles are dissected off the lamina on both sides and at multiple levels. After the spine is approached, the lamina is removed, allowing visualization of the nerve roots. The facet joints, which are directly over the nerve roots, may then be trimmed to give the nerve roots more room.
Post laminectomy, patients are in the hospital for one to three days. The individual patient’s return to normal activity is largely dependent on his/her pre-operative condition and age.
Patients are encouraged to walk directly following a laminectomy for lumbar stenosis. However, it is recommended that patients avoid excessive bending, lifting or twisting for six weeks after this surgery in order to avoid pulling on the suture line before it heals.
The success rate of a lumbar laminectomy to alleviate pain from spinal stenosis is generally favorable.
Following a laminectomy, approximately 70-80 percent of patients will have significant improvement in their day-to-day function and a markedly reduced level of pain and discomfort associated with spinal stenosis.