Spine Decompression Surgery which is also known as Laminectomy, removes the bony roof that covers the nerves & spinal cord so as to create more room for them to move freely. Stenosis or narrowing of the spinal canal can often cause numbness, chronic pain & muscle weakness in arms & legs. Most often stenosis is caused by thickened ligaments, enlarged joints & age-related osteoarthritis. Decompression therefore may be an ideal recommendation when symptoms have failed to improve with medications or physical therapy. Spine decompression surgery generally requires 1 – 3 days of hospital stay & about 4 – 6 weeks of time for recovery.
Spinal decompression procedure can be performed throughout the spine, right from the cervical (neck) region to the lumbar (lower back) region. This operation is performed through a surgical incision in the posterior back region. Lamina is the bone which forms along the backside of spinal canal, like a roof over the spinal cord. Removal of this lamina along with other soft tissues allows more space for nerves & permits removal of bone spurs. Depending upon the extent of damage due to stenosis, single-level (one vertebra) or multi-level (more than one) may be involved in the spine decompression surgical procedure.
- Laminectomy – This is removal of the entire bony lamina portion of enlarged facet joints along with thickened ligaments overlying nerves & the spinal cord.
- Laminotomy – This involves removal of small portion of lamina & ligaments, usually located on one side. Natural support of lamina is left in place with this method & thereby decreasing chances of postoperative instability of spine. Quite often, an endoscope may also be used in this procedure which allows for a smaller & less invasive incision.
- Foraminotomy – This surgical intervention involves removal of bone located around the neural foramen. Foramen is the space between vertebrae where nerve roots exit the spinal canal. This procedure is usually applied when disc degeneration has caused height of foramen to collapse & result in a pinched nerve. Moreover, foraminotomy can be performed along with laminotomy or laminectomy.
- Laminaplasty – This surgery involves expansion of spinal canal by cutting the laminae on one side only, & swinging it open like a door. However, this procedure is only used within the cervical (neck) area.
Spinal fusion in some cases may be performed at the same time in order to help stabilize sections of spine that were treated with laminectomy. Spinal fusion utilizes a combination of screws, rods & bone graft to bridge together two separate vertebrae into one new structure of bone. This fusing of two discs prevents spinal stenosis at this segment from recurring while eliminating pain from an unstable spine.
Good candidates for spine decompression surgery include the following:
- People with significant numbness, weakness or pain in foot or leg.
- People with leg pain which is worse than back pain.
- When conditions have not improved with medications or physical therapy.
- People having difficulty with standing or walking & which affects their quality of life.
- When diagnostic tests like MRI, myelogram or CT scan show stenosis in lateral recess or central canal.
Spine decompression surgery for spinal stenosis is an elective procedure, except in rare cases of rapidly progressive neurologic deficits or cauda equina syndrome. Although doctors recommend spine decompression surgery as an option for treatment, it is only the patient who will take the final call & decide whether this procedure is the right one for them. However, patients must make sure to consider all risks & benefits prior to making a decision. Spine decompression surgery however does not cure spinal stenosis nor eliminate arthritis, but it can effectively relieve some symptoms. Unfortunately, these symptoms may also recur due to the degenerative process which continues to produce spinal stenosis in patients.
Neurosurgeons or orthopedic surgeons normally perform spine decompression surgeries. Many spine surgeons in India also undergo specialized training in complex spine surgeries. Orthopaedic & spine procedures in India are performed by experts & have delivered successful outcomes which are at par with the best in the world. Orthopaedic Surgery India is associated with top specialist surgeons & accredited multi-specialty hospitals in order to provide affordable orthopedic solutions including spine decompression surgery to people from all around the world.