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| Lumbar
Laminectomy |
Lumbar
Laminectomy Surgery
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).
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.
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.
Surgery for lumbar laminectomy is performed with the
patient lying on his abdomen or side. A small incision
is made in the lower back.
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.
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.
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.
Incision Closure
The operation is completed when the back incision is
closed in several layers. Unless dissolving suture material
is used, the skin sutures (stitches) or staples will
have to be removed after the incision has healed.
Click
here for a Lumbar Laminectomy Information Sheet
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