Lumbar Laminectomy

What is a lumbar laminectomy?

Laminectomy is major surgery to decompress the spinal canal and nerves in the low back to treat pain caused by degenerative disorders of the lumbar spine, often affecting middle-aged and elderly patients when nonoperative treatment has failed. Laminectomy alone or combined with a spinal fusion is one of the most common spinal surgeries.

A lumbar laminectomy focuses on relieving compression on the spinal cord and spinal nerves. The goal of this surgery is to widen the spinal canal or facet joint space to alleviate pressure on the spinal cord or the spinal nerves and thereby relieve pain and treat symptoms that interfere with the ability to perform the functions of daily life.

What is the lamina?

The lamina is the covering over the spinal cord that forms the arch in the spine. During a laminectomy, the lamina is removed to provide access to widen the spinal canal and create more space for the spinal cord or nerve roots.

What conditions can be treated with a laminectomy?

The main indication for a laminectomy is narrowing of the spinal canal caused by multiple cause but is primarily the result of degenerative spinal stenosis. Left untreated compression of the spinal cord or spinal nerves can cause permanent damage.

• Disc herniation is a degenerative disease caused by wear and tear, a natural part of aging, that deteriorates spinal discs. A herniated disc pressing on the spinal canal is a common cause of low back pain.
• Spinal stenosis – narrowing of the spinal canal that puts pressure on spinal nerves often caused by osteoporosis. Spinal stenosis is a progressive degenerative disease that causes changes to the spinal column as a person ages.
• Radiculopathy – nerve root compression that causes pain often referred to as sciatica
• Myelopathy – a condition that causes difficulty walking, muscle spasticity, weakness, and numbness.
• To remove bone spurs and ligaments that are pinching nerves and causing pain
• To treat a slipped vertebra
• To treat a spinal fracture
• To treat spinal tumors, abscesses, and deformities.

What are the symptoms treated with a laminectomy?

• low back pain
• sciatica
• leg numbness, weakness, tingling and cramping
• difficulty walking
• balance problems
• difficulty controlling bowel and bladder function
• It is not used to treat spinal instability except when it is combined with spinal fusion.

The laminectomy procedure

It may be performed as open or minimally invasive surgery. A laminectomy is performed under general anesthesia. During the procedure Dr. Girardi will remove the lamina, to open the spinal canal and relieve pressure that is causing symptoms. Dr. Girardi may perform a discectomy, removal of a damaged disc; a foraminotomy a procedure to open the spine where nerve roots that leave the spinal canal are compressed; or spinal fusion, a procedure to permanently join two vertebrae to eliminate movement between the affected vertebrae.

Preoperative planning

Patients who have narrowing of the spinal canal will be evaluated with x-rays, and an MRI to confirm spinal stenosis and identify all conditions that are causing impingement of the spinal canal or nerve roots. Diagnostic injections may be ordered to determine the exact location of the stenosis that is causing your symptoms.

General surgical risks

Laminectomy provides symptom improvement and early recovery with low complication rates.

The risks of anesthesia, bleeding and infection are common to all major surgeries. Risks of all spine surgeries include infection, damage to spinal nerves that can cause weakness, pain, and loss of sensation, and partial or limited pain relief.

Dr. Federico Girardi specializes in the surgical treatment of spine disorders and has extensive experience in minimally invasive spine surgery. Dr. Girardi is internationally renowned, trains spine surgeons world-wide in advanced surgical skills including minimally invasive spine surgery and has extensive clinical research experience.

Contact his office to schedule a consultation at the Hospital for Special Surgery (HSS) in Manhattan. HSS is the number one US hospital in Orthopedics.