The lumbar area of the spine is better known as the lower back. The lamina
is a part of each vertebra. A lumbar laminectomy is the surgical removal
of the lamina or part of the lamina on one or more of the vertebrae in
the lower back. This is usually done to relieve pressure on nerves that
may become inflamed from pressure caused by a narrowed spinal canal, bone
spurs, or a herniated disc.
Once the lamina is removed, the surgeon can then access the spinal canal
and remove the source of irritation or pressure.
Who is a candidate for a lumbar laminectomy?
Those who suffer from frequent lower back pain and perhaps leg pain and
numbness may have a condition known as spinal stenosis. Spinal stenosis
describes the narrowing of the spinal canal in the area where the nerves
and nerve roots exit the spinal column.
This narrowing can occur as a result of arthritis in the spine, by calcium
deposits, or simply by the wear and tear that occurs from repetitive stress
on the lower spine. In addition, some people are born with a narrow spinal
canal that becomes symptomatic as they age.
The narrowing of the spinal canal may eventually cause pressure on the
nerves and nerve roots that emerge from the spinal column. This irritation
can result in pain and numbness, particularly after sitting or standing
for extended lengths of time. Lumbar laminectomy may be recommended in
order to make more room for the nerves or nerve roots.
Another condition that is often treated with a lumbar laminectomy is a
herniated disc. The discs act as cushions or "shock absorbers"
between the vertebrae. Part of the disc may herniate or bulge into the
canal, again putting pressure on the nerves. Once the laminectomy is performed,
the surgeon may trim or remove whatever material is causing the irritation.
What are the alternatives to a lumbar laminectomy?
Surgery is usually the last option considered. If your symptoms are mild,
you may not require any treatment at all. Other conservative treatments
such as physical therapy, medications, and steroid injections may relieve
symptoms for a time; however they usually do not permanently change the
underlying cause of the problem – the narrowing of the spinal canal.
In some cases, lumbar laminectomy may be the only solution to remove irritation
and create more space for the nerves.
How are back problems evaluated?
Your doctor will use a number of approaches to evaluate and diagnose back
problems, such as spinal stenosis or a herniated disc. These include:
A Detailed History – Your role in providing a detailed history is very important. Your
doctor will need to know where and when it hurts, if there was a recent
injury or fall, and a description of the pain. Are there positions or
activities that make it feel worse? What makes it feel better? All of
these details can help your doctor pinpoint the problem.
A Physical Exam – Once your history is given, a thorough exam by a back expert is
another important step in getting a good diagnosis.
Diagnostic Imaging – X-rays can show the structure and alignment of the vertebrae, as
well as the presence and size of bone spurs or other bony abnormalities.
Computerized Tomography (CT) – This is a special kind of X-ray machine. Rather than a single X-ray,
a CT scanner sends out a number of beams at different angles. These images
are then read by a computer, producing detailed cross-sections or "slices"
that can show the shape and size of the spinal canal and the surrounding
Magnetic Resonance Imaging – MRI uses a very powerful magnet to send radio waves into the body.
The images produced are very helpful in visualizing the soft tissues,
such as the spinal cord itself, as well as the discs and nerve roots.
Bone Scans – These are useful in revealing abnormalities such as infections,
fractures, tumors and arthritis. Because bone scans are unable to differentiate
between these problems, they are usually performed in conjunction with
other diagnostic tests.
How long is the hospital stay?
The time spent in the hospital depends on several factors, including your
overall health and the extent of our particular surgery. Some people may
be able to return home the same day, while others may spend one to two
days in the hospital.
How long will it take to recover?
Recovery time after a lumbar laminectomy varies depending on your particular
situation, the number of levels involved, as well as your general health.
The key to a successful recovery is maintaining a positive attitude.
You will be able to take short walks while in the hospital, and need to
gradually increase the distance and frequency of your walks once at home.
Avoid standing or sitting for prolonged periods and change your position
frequently to help minimize back spasms and discomfort.
To find a physician affiliated with the San Diego Spine & Joint Center
at Paradise Valley Hospital,
click here or call (844) PVH-CALL (844-784-2255) and a friendly representative will
Just give us a call. We'll be happy to answer any questions you may
have. And be sure to ask us about our upcoming seminars on back and neck
pain – we'd love to see you! For more information, call us 24/7
at (844) 784-2255, or you can
e-mail our spine and joint care coordinator.