Laminectomy, also known as Decompression Surgery, is a surgical procedure performed to remove a portion or all of the vertebral bone, called the lamina.
Laminectomy is an elective procedure.
Laminectomy can be performed in any portion of the spine. Depending on the location of the surgery, Laminectomy is classified as the following:
The primary reason for performing a Laminectomy surgery is to relieve pressure on the spinal cord and nerves that are caused due to abnormal growth of bones within the spinal canal. The abnormal bony outgrowths compress the spinal canal resulting in various complications. However, decompressive Laminectomy does not cure any spine problems neither can it prevent permanent nerve damage caused by long-term spinal cord compression.
Laminectomy surgery is recommended in the following cases:
Laminectomy surgery is also performed in association with spinal surgeries such as herniated disc surgery and spinal fusion.
Absolute contraindications for not performing a Laminectomy surgery are spinal instability. Other relative contraindications include degenerative or isthmic spondylolisthesis, severe scoliosis, and severe kyphosis.
Investigations that are done before performing a decompressive Laminectomy surgery are imaging tests like MRI and CT scans to identify the spinal deformity and to determine the severity of the condition.
Before performing a decompressive Laminectomy surgery:
Anaesthesia: A Laminectomy surgery is performed under general anaesthesia.
Throughout the surgery heart rate, blood pressure, and blood oxygen levels are monitored. The surgical area on the back is cleaned with an antiseptic solution. After administration of general anaesthesia, an incision is made on the back over the affected vertebrae. The size of the incision depends upon the medical condition for performing the decompressive Laminectomy surgery. The incision is gently carried down to move the muscles apart from the spine.
Small surgical instruments are used to remove the bony arch of the vertebra called the lamina. An appropriate portion of the lamina is removed. Any abnormal bony spurs or growths are also removed. Spinal surgeries like disc herniation surgery, spinal fusion, or spinal tumor removal are also performed during Laminectomy if required. At the end of the surgery, the incision is closed with stitches and a sterile bandage is applied over the incision site.
Laminectomy surgery may be performed via two approaches:
MicroLaminectomy: This is a minimally invasive approach. Small incisions are made on the back. An arthroscope is inserted through one of the incisions. An arthroscope is an instrument with a tiny video camera on its tip, which displays the magnified view of the spinal structures on the monitor. Surgical instruments are inserted through other incisions for performing a decompressive Laminectomy. This type of approach results in a smaller incision, less pain, and faster recovery. It causes less damage to tissues and surrounding organs.
Open surgery: This type of approach requires a large incision in the back over the affected vertebra. The length of the incision depends on how many vertebrae are affected and needs treatment. The open approach allows direct visualization and access to the surgical area. It involves more cutting and displacement of muscle and other tissues. However, the open surgery approach is a safe and more effective method in certain cases.
Postoperatively after a decompressive Laminectomy surgery:
Aftercare instructions of a decompressive Laminectomy surgery are:
Complications that arise from a Laminectomy surgery are:
The overall prognosis of Decompression surgery varies from individual to individual. In 80% of the cases, Decompression surgery decreases pain and improves symptoms caused by spinal deformities. In some cases, there may not be considerable pain relief after the surgery. The success rate of the surgery depends on the specific reason for the operation.
If the surgery performed is just Laminectomy, it can be done on an outpatient basis and the individual can be discharged on the same day of surgery. If the procedure is associated with any spinal surgery, hospitalization is required.