Treatments & Therapies

Laminectomy – Treatment, Effect and Risks

Laminectomy

Laminectomy is a surgical procedure to treat the spine . The method serves to remove the vertebral arch together with the spinous process.

What is the laminectomy?

The laminectomy ( spinal canal operation ) is one of the surgical procedures on the spine. In this surgical treatment, the vertebral arch is removed from one or more vertebrae together with the spinous process.

In this way, space can be created for a surgical intervention on the intervertebral discs or on the spinal cord . In the case of an existing tumor within the spinal canal, it is possible to reduce the resulting high pressure. The term laminectomy is composed of the Latin term lamina arcus vertebrae and the Greek term ectomy. Translated into German, the term means “removal of the vertebral arch”. If only one half of the vertebral arch is removed, this is referred to as a hemilaminectomy.

The first laminectomies were performed by British physicians William McEwen (1848-1924) and Victor Alexander Haden Horsley (1857-1916) in London at University College in 1886. During World War I, laminectomies were often performed in field hospitals to treat spinal cord injuries such as punctures or gunshot wounds.

Function, effect & goals

A laminectomy is used, for example, in the case of progressive spinal canal stenosis, in which the spinal canal narrows. The aim of the intervention is to reduce the pressure exerted on the nerve root and the efferent nerves in the spinal canal region. In this way, the associated complaints such as back pain can be effectively combated. In order to relieve the pressure on the nerve cords, the constricting structures are removed as part of the laminectomy.

In recent years, however, minimally invasive procedures such as microsurgical decompression have increasingly replaced laminectomy. These methods have the advantage of having less negative impact on spinal stability. The vertebral arch and the vertebral joints on the side remain largely intact. A laminectomy is only performed when conservative treatment, which usually consists of physiotherapeutic measures and the administration of painkillers , is unsuccessful and the back pain does not improve.

When performing a laminectomy, the patient lies on their stomach . He is also given general anesthesia . With an X-ray examination , the surgeon is able to determine the exact location of the spinal canal stenosis. He draws this spot on the skin before the procedure . The first step in laminectomy is to make an incision in the skin. The back of the spine is then exposed. For this purpose, the surgeon loosens the musclesfrom the vertebral arches. The structures that narrow the spinal canal can be removed by using high-speed bone cutters, bone chisels and punches. In order to be able to relieve the pressure sufficiently, the surgeon operates on parts of the vertebral arch and the spinous process.

If there is nerve constriction on both sides, it is usually necessary to remove the entire vertebral arch together with the ligaments so that the back pain can be successfully improved. If, on the other hand, it is only a one-sided narrowing, a hemilaminectomy is usually considered sufficient. It is also possible to remove an additional herniated disc. At the end of the laminectomy, a drainage tube is usually inserted into the treated region. In this way, the wound fluids can also drain off after the procedure. The hose can be removed just one day later.

A variant of laminectomy is microsurgical decompression. In this case, only a very small incision is made in the skin. The surgeon has special instruments with angulation and a surgical microscope. With this procedure, the muscle attachments that are located on the vertebral arches can be spared. Another difference to the laminectomy is that only a small part of the vertebral arch has to be removed. With the help of tiny punches and chisels, the surgeon hollows out the spinal canal from the inside. In addition, all constricting parts are removed.

Risks, side effects & dangers

After the laminectomy, it is necessary to empty the patient’s bladder with a catheter for the first few days. After one to three days, however, the functions of the bladder and intestines have usually returned to normal.The patient is usually able to stand up again a day after the operation. However, he has to practice standing up correctly with the help of doctors and physiotherapists so that his spine does not twist. The spine can be further stabilized with a support corset with an elastic effect. The patient regains full physical capacity after about six weeks. During this period he should carry out important physiotherapy exercises.

As with most surgical procedures, there is a risk of complications with laminectomy. These include primarily nerve injuries . These become noticeable in the form of movement disorders , sensory disorders, functional disorders in the intestines and urinary bladder as well as sexual problems. However, these side effects are only recorded in around one percent of all patients. In addition, the laminectomy is only performed if there is already damage to the nerves due to the narrowing.

Other possible complications include wound healing disorders and infections, which are part of the general risks of surgical interventions. With a microsurgical operating procedure, this risk is significantly lower. In rare cases, the spinal canal narrows again after the laminectomy. Doctors then speak of a postlaminectomy syndrome.

Typical & common spinal diseases

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.