What is lumbar laminectomy?
Lumbar laminectomy is a surgical procedure that is performed to alleviate persistent, often debilitating pain caused by pressure on the nerves (neural impingement), a herniated disc or a tumor on the spine. Low back pain from problems in the lumbar (lower) spine can range from mild, dull or annoying to persistent, severe and debilitating. Pain in the lumbar region of the back can restrict mobility and interfere with normal functioning and activities.
Structure of the lumbar spine
The spinal column, also called the vertebral column or backbone, is made up of 33 vertebrae that are separated by spongy disks. Five of the vertebrae are in the lower back area (lumbar region) of the spine. The vertebrae and bones are joined with other parts of the spinal structure, including:
- Lamina—The bony arch on the posterior (back) part of the vertebrae that is over the spinal column. This is the part of the spine that is removed during a laminectomy.
- Discs—Soft, shock-absorbing cushions between the bones of the vertebrae that allow the back to bend while preventing the vertebrae from rubbing against each other.
- Spinal cord—The bundle of nerves that connects the brain to the rest of the body. The spinal cord passes through the center of the vertebrae.
- Spinal nerves—These nerves may become compressed or “pinched” by a vertebra or disc.
- Muscles and ligaments—Support and protect the spinal column, providing both strength and flexibility.
Why it's done
In addition to injuries and spinal tumors, lumbar laminectomy can be used to treat:
- Lumbar spinal stenosis—Spinal stenosis occurs mostly in elderly patients and is caused by degenerative changes that result in narrowing of the spinal column and enlargement of the facet joints (small joints that connect the vertebrae). When the facet joints are enlarged, they place pressure on the spinal cord and the nerve roots that branch out from it. Nerve compression can cause severe pain and other nerve-related problems that can be debilitating. Lumbar laminectomy surgery is effective for decreasing pain and improving function for patients who have lumbar spinal stenosis.
- Herniated (ruptured) disc—Discs are shock-absorbing cushions that sit between the vertebrae of the spine and prevent the vertebral bones from rubbing against one another. A herniated disc can be the result of degeneration associated with overuse or aging or it can be caused by injury or disease. When discs rupture, they bulge outside of their normal position between the vertebrae and can press on the spinal cord and the nerve roots that branch out from the spinal cord. Ruptured (herniated) discs can cause instability in the spine, abnormal movement and severe nerve compression symptoms such as pain, weakness, numbness and tingling in the neck and arms.
What to expect
Lumbar laminectomy surgery is considered only if nonsurgical treatments have proven to be ineffective. During the surgery, the spine surgeon removes a small portion of the bone over the nerve root (lamina), as well as disc material from a herniated or ruptured disc that may be under the nerve root. This gives the nerve root more space and an opportunity to heal.
Lumbar laminectomy surgery has a favorable success rate. Approximately 70 to 80 percent of patients have significant improvement in their ability to perform normal daily activities, as well as a noticeably reduced level of pain and discomfort.