Treatment Options

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Lumbar Laminectomy/Discectomy

A lumbar laminectomy/discectomy is a procedure used to relieve pressure on the nerves in the lower back. It is a procedure intended to relieve symptoms including leg pain, numbness and/or tingling and/or weakness caused by compression of nerves in the low back by bone spurs and/or disc herniations.

INDICATIONS FOR LUMBAR LAMINECTOMY/DISCECTOMY

The majority of the time patients who have symptoms of sciatica from disc herniation and/or bone spurs do not require surgical treatment. Most people can find relief with nonsurgical methods. It is when these nonsurgical methods do not adequately provide patients with the degree of comfort that they need, and/or the pain is interfering with their quality of life, that a lumbar laminectomy/discectomy is indicated. In cases when patients have significant weakness more urgent surgery may be warranted. Patient’s symptoms typically include back pain but more commonly buttock and/or hip and leg pain associated with numbness, tingling and/or weakness. This can be present in one or both lower extremities. Rarely patients can have symptoms of bowel and bladder dysfunction which would require more urgent surgical treatment.

LUMBAR LAMINECTOMY/DISCECTOMY PROCEDURE

Surgery is typically performed under general anesthesia. The patient is typically laying on their stomach and/or in a kneeling position. For a one level lumbar laminectomy and/or discectomy due to a ruptured disc a small incision is made. If multiple levels are involved secondary to arthritis and bone spurs typically the incision will be bigger. The muscles and soft tissues are gently retracted to expose the spinal canal. In cases of a ruptured disc a small amount of the bone (lamina) is removed along with the ligament covering the spinal canal. The nerve root is identified and gently retracted and the piece of disc material that is ruptured is removed, thereby relieving pressure on the nerve. In cases where the spinal canal is narrowed secondary to thickened spinal ligament, called the ligamentum flavum, and/or bone spurs, a more significant amount of bone and ligament are removed in order to relieve pressure on the spinal canal.

POSTOPERATIVE COURSE

For a one level lumbar laminectomy/discectomy due to a disc herniation most patients can either go home the same day of surgery or the day after surgery. Typically, patients have some degree of low back pain that is managed with appropriate pain medications and muscle relaxers. Most patients notice that their leg symptoms are markedly better than they were preoperatively. Patients can continue to have some residual symptoms of numbness and tingling and/or weakness that can continue to improve for up to 18 months after surgery. Patients can typically return to work within two to six weeks after surgery, depending on the physical nature of their work. Patients who undergo a multilevel lumbar laminectomy typically are in the hospital for two to three days after surgery but are up and walking the day after surgery.

POTENTIAL RISKS AND/OR COMPLICATIONS

As with any surgical procedure there are inherent risks. These include risk of anesthesia, nerve damage, blood clots, bowel and bladder dysfunction, numbness and tingling, incomplete pain relief. The potential risks and complications of surgery will be discussed with the patient thoroughly prior to surgery.

Blue Distinction Center for Spine Surgery