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A laminectomy is designed to relieve compression of the spinal nerves. In this respect, it is similar to a Discectomy.
However, in this case, part of the vertebral lamina is removed (sometimes to gain access to a Bulging, or Herniated disc), hence the term laminectomy.
The red circle, on the diagram below, indicates the area of bone that is typically removed.
A laminectomy is often used to combat spinal stenosis, a degenerative bone condition that causes the facet joints to increase in size (hence increasing the pressure on the nerve-roots).
Typically, the procedure involves the following steps:
an incision is made in the mid-line of the back;
the skin and back muscles are retracted to allow access to the lamina;
the lamina is removed; at this stage, the posterior aspects of both the inter-vertebral disc and nerve root can be seen;
the enlarged facet joints are trimmed and/or part of the disc is removed.
Surgeons claim that laminectomies are usually successful in terms of their clinical outcomes. However, we strongly disagree: patients are usually worse off after the procedure.
Like other forms of spinal surgery, a laminectomy does not treat the cause of the problem. All three of the conditions named above (Bulging Disc, Herniated Disc, and spinal stenosis) are essentially caused by compression of the spine; all three are promoted by aging, and other risk factors such as obesity.
So what good does it do, to remove part of the lamina, disc and/or facet joints? Localised decompression might be obtained for a short period of time, but the underlying causes will persist and the operation itself weakens the spine and leaves it more susceptible to injury. Scar tissue and adhesions soon develop, often resulting in pain and crippling debilitation (the clinical impact of adhesions cannot be under-estimated).
In addition to this, nerve root damage is always a risk (all surgical techniques restrict the flow of blood to the area in question, and this heightens the risk of injury). When the nerve root is retracted, for example, it is possible for it to become bruised (a ‘contused’ nerve root), even in the most experienced of hands.
A contused root is initially very painful and many patients continue with severe, disabling pain for many years. They complain that the pain is stabbing, shooting, burning and very unpleasant. The chances of recovery from nerve root injury are poor, and the symptoms are often very severe; in all cases, the patient will experience sensory or motor symptoms (or both) and these manifest themselves in different ways depending on the level of the spine affected.
We strongly advise all of our patients not to undergo spinal surgery.
Instead, we believe the correct approach is to decompress, or mobilise, the spine using completely non invasive techniques i.e. techniques that are based on Orthopaedic Medicine. Decompressing the spine in this way (mechanically, not surgically) will successfully treat most conditions.
To receive non-invasive treatment, you can visit our Spine Clinic. You can also receive a Diagnosis filling the on-line Consultation Form. For those people who can neither afford personal treatment, nor make the trip to London, we recommend that you purchase a Backrack™.For those who wish to understand the risks involved in spinal surgery from people who have already undergone the procedure we recommend that you visit our Spine Guestbook page and/or directly our Patients’ Forum page.
Usually paid by the NHS or private insurance; complications during/after surgery will result in additional cost.