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Spinal Stenosis Surgery

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Laminectomy

Surgery for spinal stenosis is most commonly accomplished through a laminectomy. A laminectomy is performed to relieve pressure from the spinal cord or spinal nerve roots.  The pressure could be caused by multiple complications such as, degenerative disc disease, traumatic injury to the spine, disc problems such as a herniated disc, or a tumor.  Once the pressure is relieved, painful symptoms will usually go away.

A Laminectomy creates more room in the spinal canal by removing parts of the vertebrae and or thickened tissue that are constricting it.

Depending on the extent of the spinal stenosis surgery a fusion may be required to provide added stability for the spine.  Spinal fusion surgery is a major surgery that lasts for several hours and requires hospitalization and long recovery.

Harvesting the bone is performed in a few different ways and your doctor will talk to you about what their opinion is on which one is more suited for you.

• The most common method is an autograft where the bone is harvested from another area in your body (usually the hip).  The harvested bone is used to fuse two vertebras together to stabilize the spine.  The bone will eventually grow completing the fuse.
• There are some cases where there is need for additional instrumentation.  This is commonly referred to as instrumented fusion and makes use of instruments such as hooks, rods, wires, plates and screws to add additional support to the spine until the bone fuses.

Laminotomy

Laminotomy is a minimally invasive arthroscopic procedure used to treat spinal stenosis by gaining access to the spinal canal without any need for general anesthesia.  For this reason the spinal stenosis surgery may be performed in an outpatient surgical setting.

A laminotomy relieves pressure from the spinal canal allowing more room for exiting nerve roots and the spinal cord.  With the increased space neural tissue that is being compressed should now have enough room and the pain being caused should subside.

During surgery for spinal stenosis the lagamentum flavum may also be removed.  This is a ligament in the spinal canal that can thicken as we age.  As it thickens the area around the spinal cord becomes compressed which leads to the development of spinal stenosis.

When the ligament is removed, the choking it caused will no longer exist and the pain should subside.

Spinal stenosis surgery procedure

A laminotomy uses a local anesthetic to numb the area where the incision is made in the back. This is a small incision where a Depuy tube is inserted.  Gradually larger tubes are placed over the Depuy tube eventually increasing its size to about 18 millimeters (the size of a small marker). Once the working tube is in place the surgeon will begin the procedure.  The surgeon manipulates the laser, camera, suction, irrigation and various other surgical instruments through this tube used to gain access to the spinal canal.  This procedure is minimally invasive in nature as it pushes the muscles and tissue out of the way instead of the cutting and tearing that is common in conventional open back surgery.  Once the surgery is complete one or two stitches are used to close the incision and the patient is then monitored for one to two hours.