Decompressive laminectomy

Decompressive laminectomy is a surgical procedure performed to relieve pressure on the spinal cord or nerve roots that is caused by age-related changes, tumors, herniated discs, or spinal stenosis. It involves the removal of the lamina, the back part of the vertebra that covers the spinal canal. This operation expands the spinal canal to alleviate the pressure on the spinal cord or nerves, aiming to improve symptoms such as pain, weakness, or numbness in the arms or legs.

Indications

Decompressive laminectomy is indicated for patients who suffer from significant neurological deficits due to compression of the spinal cord or nerve roots. Common conditions leading to this procedure include:

• Spinal stenosis: Narrowing of the spinal canal, often due to aging.
• Herniated disc: When the disc protrudes and puts pressure on the spinal cord or nerve roots.
• Tumors: Abnormal growths within the spinal canal.
• Spondylolisthesis: A condition where one vertebra slips forward over another.

Patients typically undergo conservative treatments such as physical therapy, medications, or injections before surgery is considered. Surgery is recommended when conservative measures fail to improve symptoms or if symptoms rapidly worsen.

Procedure

The procedure is performed under general anesthesia. The surgeon makes an incision in the midline of the back over the affected vertebra(e). The muscles are moved aside to expose the lamina. The lamina is then removed (laminectomy), along with any bone spurs or parts of herniated discs that are compressing the nerves. In some cases, a procedure called a spinal fusion may be performed in conjunction with a laminectomy to help stabilize the spine.

Risks and Complications

As with any surgery, decompressive laminectomy carries risks and potential complications, including:

• Infection
• Bleeding
• Blood clots
• Nerve injury
• Spinal instability
• Recurrence of symptoms

Recovery

Recovery from a decompressive laminectomy varies depending on the individual's overall health, the extent of the surgery, and whether spinal fusion was performed. Hospital stays can range from a day to several days. Physical therapy is often recommended to help strengthen the back and improve mobility. Full recovery can take several weeks to months.

Outcomes

Many patients experience significant relief from pain and improvement in function after a decompressive laminectomy. However, outcomes can vary based on the underlying condition being treated, the patient's age, and overall health.