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.