Procedure: Lumbar Laminectomy

A lumbar laminectomy is a surgical procedure performed by a spine surgeon to relieve pressure on a spinal nerve in the low back. Another term for a laminectomy is spinal decompression meaning it removes tissue that is compressing a nerve. Tissues that may compress a nerve in the lumbar spine include bone (eg, osteophyte) and/or disc material (eg, herniated disc).

How the Procedure Is Performed
The patient is usually positioned face down on the operating table. The length of the surgical incision depends on the number of levels to be treated. In other words, a single level laminectomy (eg, L2-L3) may only require a small incision, whereas a multilevel laminectomy (2 or more) may necessitate a 3 to 4-inch incision. Another consideration is if the surgery is a traditional open procedure or to be performed minimally invasively.
Senior patient looking over x-ray with DoctorA lumbar laminectomy is a surgical procedure used to relieve pressure on a spinal nerve. A traditional open surgical approach may involve a retractor to spread apart the muscles and fatty tissue of the spine to expose the vertebra’s lamina. A portion of the lamina is removed to uncover the ligamentum flavum; an elastic-like ligament that connect two vertebrae.

Read …. Outpatient Minimally Invasive Lumbar Laminectomy

Next, the surgeon cuts an opening in the ligamentum flavum to reach the spinal canal. Once the compressed nerve can be seen, the cause of nerve compression can be identified. Most cases of spinal compression are caused by a herniated disc. However, other sources of pressure that can cause compression may include:

The surgeon gently retracts the nerve, and the source of the compression is removed—the pressure on the spinal nerve or nerve components is relieved.

If necessary, the surgeon will perform a spinal fusion with instrumentation to help stabilize the spine. Fusion and instrumentation may be necessary if quite a bit of bone is removed and/or multiple levels of the lumbar spine are treated. A spinal fusion involves bone graft, such as the patient’s own bone (autograft) and packing it into and around the spinal instrumentation (eg, rods, screws, plates). Bone graft helps stimulate new bone growth and promotes healing.

After the lumbar laminectomy procedure, the soft tissues that were retracted are allowed to move back into place and the incision is closed using suture and/or staples.

Updated on: 05/31/18
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