A lumbar laminectomy is a process in which a surgeon removes part or all of the vertebral bone in the lower back to relieve compression of the spinal cord or the nerve roots that may be cause by an injury, spinal stenosis, tumors, or a herniated disk. If spinal stenosis is the main cause of your back pain, the spinal canal must be made larger. Any bone spurs pressing on the nerves must also be removed. One way that this is done is with a complete laminectomy. Laminectomy means “remove the lamina.” Removing the lamina and any bone spurs gives more room for the nerves. A laminectomy reduces the pressure on the spinal nerves, thereby decreasing any irritation or inflammation.
A laminectomy is usually performed when back pain continues after medical treatment, or when the back pain is accompanied by symptoms of nerve damage, such as numbness or weakness in the legs.
To perform a lumbar spine laminectomy, an incision is made down the center of the lower back. The muscles are then moved to the side. Once the spine is reached from the back, each vertebra is identified. The surgeon will probably take an X-ray during surgery to ensure that the correct vertebrae and laminae are identified. Once this is determined, the lamina of the affected vertebra is removed. Any bone spurs that are found sticking off the back of the vertebrae are removed as well. Great care is taken to not damage the spinal nerve roots.
In the lumbar spine, removing the lamina completely may cause problems with the stability of the facet joints between each vertebra. If these joints are damaged during the laminectomy, the spine may begin to tilt forward causing problems later. Sometimes removal of part or all the facet joints is unavoidable.
The surgeon sometimes has to remove too much of the facet joints during a laminectomy. In this case, a fusion may also be required at the same time to make sure there are no problems later. The surgeon will probably discuss this possibility with you before surgery.