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Laminectomy Animation |
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Traditonal
Lumbar Laminectomy
What is It?
Lumbar laminectomy is an operation performed on the lower spine to relieve
pressure on one or more nerve roots. The term is derived from lumbar
(lower spine), lamina (part of the spinal canal's bony roof), and -ectomy
(removal).
Why is it Done?
Pressure on a nerve root in the lower spine, often called nerve root
compression, causes back and leg pain. In this operation the surgeon
reaches the lumbar spine through a small incision in the lower back.
After the muscles of the spine are spread, a portion of the lamina is
removed to expose the compressed nerve root(s).
Pressure is relieved by removal of the source of compression
part of the herniated disc, a disc fragment, a tumor, or a rough protrusion
of bone, called a bone spur.
What Happens Afterwards?
Successful recovery from lumbar laminectomy requires that you approach
the operation and recovery period with confidence based on a thorough
understanding of the process. Your surgeon has the training and expertise
to correct physical defects by performing the operation; he and the
rest of the health care team will support your recovery. Your body is
able to heal the involved muscle, nerve, and bone tissues. Full recovery,
however, will also depend on your having a strong, positive attitude,
setting small goals for improvement, and working steadily to accomplish
each goal.
The Operation
Incision
 Surgery
for lumbar laminectomy is performed with the patient lying on his abdomen
or side. A small incision is made in the lower back.
 Laminectomy
After a retractor is used to pull aside fat and muscle, the lamina
is exposed. Part of it is cut away to uncover the ligamentum flavum
- a ligament that supports the spinal column.
Entering the Spinal Canal
Next an opening is cut in the ligamentum flavum through which the spinal
canal is reached. The compressed nerve is now seen, as is the cauda
equina (bundle of nerve fibers) to which it is attached. The cause of
compression may now also be identified - a bulging, ruptured or herniated
disc, or perhaps a bone spur.
 Sometimes
a fragment of disc has moved away from the disc space to press on the
nerve root as it leaves the spinal canal. This will often cause more
severe symptoms. Because of its distance from the disc space, the fragment
may not be seen on a myelogram, and a CT scan (computerized x-ray) may
be required to locate it.
Removal of the Herniated disc
The compressed nerve is gently retracted to one side, and the herniated
disc is removed. As much of the disc is taken out as is necessary to
take pressure off the nerve. Some surgeons will remove all "safely
available" disc material. After the cause of compression is removed,
the nerve can begin to heal. The space left after removal of the disc
should gradually fill with connective tissue.
Fusion and Instrumentation
 Incision
Closure
The operation is completed when the incision is closed in several
layers. Unless absorbable suture material is used, the skin sutures
(stitches) will have to be removed after the incision has healed.
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