Lumbar Laminectomy and Laminotomy

For treatment of Spinal Stenosis and Sciatica

The lower area of the spine is better known as the lower back. The lamina is part of the vertebrae. A lumbar laminectomy is the surgical removal of the entire lamina; a lumbar laminotomy is when only a portion of the lamina is removed on one or more of the vertebrae in your 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 partially or fully removed, the surgeon can then access the spinal canal and remove the source of irritation or pressure.

Who is a candidate for this procedure?

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 by the wear and tear that occurs from the 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 nerve and nerve roots that emerge from the spinal column. A laminectomy or laminotomy may be recommended to make more room for the nerves or nerve roots.

A herniated disc is another condition that is often treated with a lumbar laminectomy or laminotomy. The discs act as cushions or “shock absorbers” between the vertebrae. Part of the disc may herniate or bulge into the canal putting pressure on the nerves. Once the procedure is performed, the surgeon may trim or remove whatever material is causing the irritation.

Conservative treatments include physical therapy, medications and steroid injections. In some cases, however, surgery may be the only solution.

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? All of these details can help your doctor pinpoint the problem.
  • A Physical Exam – 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.
  • CT – A CT scanner produces cross-sections or “slices” that show the shape and size of the spinal canal and the surrounding structures.
  • MRI – The images produced are very helpful in visualizing the soft tissues.
  • Bone Scans – These are useful in revealing abnormalities, such as infections, fractures, tumors and arthritis.

How long will it take to recover?

Recovery time after a lumbar laminectomy or laminotomy varies depending on your particular situation, the number of levels involved, as well as your general health. Some people may be able to return home from the hospital the same day, while others may spend one to two days recovering.

The key to a successful recovery is maintaining a positive attitude. Your doctor will give you specific instructions on activity levels, including when you can resume driving and return to work.

Contact Us for More Information or Physician Referral

We are happy to answer your questions. Our nurse navigator can be reached at (619) 229-4548 or by e-mail. To find an orthopedic or spine surgeon affiliated with our program, please click here or call (800) 258--2723.