A laminectomy is a spinal procedure designed to lower pressure within the spinal canal (spinal stenosis). When it is performed in the low back region for lumbar stenosis, it is known as a lumbar laminectomy, and when in the neck region for cervical stenosis, it is a cervical laminectomy. During a lumbar laminectomy or cervical laminectomy, the back region of the vertebra, called the lamina, is removed to expand the spinal canal and relieve pressure on the spinal cord (cervical stenosis in the cervical spine), or the nerve roots ( lumbar stenosis in the lumbar spine). Spinal discs (the shock-absorbing pads in between the vertebrae) may rupture or otherwise become displaced. This can raise pressure within the spinal canal or even compress the spinal cord, causing extreme pain and possibly a loss of mobility. As the spinal canal houses the spinal nerves that run through the spinal column, any bone growths, spurs, or herniated disks have the potential to compress these spinal nerves or spinal cord, depending on the level of the spine where the compression occurs. Thickened ligament in the spine may also compress the nerves in the lumbar spine, or the spinal cord in the cervical spine, because the spinal cord travels through the cervical spine, but ends at the top of the lumbar spine, below which only the spinal nerves run within the lumbar spine. The ligament which often thickens with aging, is known as the ligamentum flavum. Depending upon where the source of compression of the spinal canal occurs, the surgeon can approach the spine from the front or the back. When the decompression is from the back, to remove the lamina of the spine, the procedure is known as a laminectomy.
Most commonly, a laminectomy is performed on patients who suffer from spinal stenosis, a condition in which the spinal canal at certain points is narrower than normal. Symptoms vary widely, with some patients reporting extreme pain and a loss of mobility from compressed spinal nerves or spinal cord. In a much less common situation, bladder problems can occur from pressure placed on spinal nerves (lumbar stenosis) in the lumbar spine on the cauda equina nerves traveling to internal organs. Patients with cervical stenosis may experience neck pain, or pain in the upper extremities, or in more severe cases, may experience partial or complete paralysis. When patients with cervical stenosis suffer an injury, they may experience trauma to the cervical spinal cord, resulting in a spinal cord injury. This could result in paralysis below the level of injury of the spinal cord, or another type of cord injury in which the arms are weak, but the legs are strong (known as central cord syndrome). Other patients’ quality of life may be relatively unchanged, although if sufficient pressure is placed on the cervical spinal cord, a posterior cervical laminectomy may be recommended to reduce the chances of further trauma.
Depending on the extent of the pressure placed on the spinal canal, the surgeon may remove parts of the lamina on both sides of the spinal column, in addition to any fragments of bone or disk that are causing the obstruction. Spinal fusion, a procedure in which vertebrae are fused together to ensure stability, may be necessary depending on the total bone loss sustained during the laminectomy, and any foreseen instability of the spine resulting from extensive bone removal. At times, the degeneration of the spine and overgrowth of bone spurs is so severe, that in order to fully decompress the spinal cord in the neck (cervical stenosis) with a cervical laminectomy, or the spinal nerves in the lumbar spine (lumbar stenosis) with a lumbar laminectomy, part or all of the facet joints (which connect the vertebral body above with the one below) may need to be removed. When this occurs, the spine may become unstable at that segment, and a spinal fusion at that segment may be considered.
Patients who are experiencing numbness or pain down one or both legs are advised to seek medical attention. Although there are several different possible causes for the compression of spinal nerves, symptoms may not fully indicate the seriousness of the condition. Continued compression can eventually cause permanent loss of sensation, as well as paralysis of the extremities. Paralysis of the legs, from lumbar stenosis, is very uncommon, but in rare situations, can occur, particularly is the lumbar stenosis is sudden and severe in onset, such as a severe and large herniated disc, or a spine injury fracture. Patients who experience numbness or pain down one or both arms are also advised to seek medical attention. If a patient feels a “electric shock” traveling down the spine, known as a Lhernitte sign, the patient may be suffering from spinal cord compression in the neck (cervical spine). In this situation, the patient should definitely make an urgent appointment to see a spine surgeon. Following a cervical laminectomy or lumbar laminectomy, a physical therapy regimen to maintain mobility and strengthen the core will give patients the best chance at restoring stability to their spinal columns. Core strengthening can be accomplished with physical therapy or by chiropractic treatment with a chiropractor.
Expert neurosurgeons at the Kraus Back and Neck Institute (KBNI) in Houston, TX, have significant experience in treating cervical stenosis and lumbar stenosis. At times, they are able to treat patients and improve their symptoms without the need for surgery. When the cervical stenosis or lumbar stenosis is moderate or severe, or the symptoms the patient experiences are unrelenting, a lumbar laminectomy or cervical laminectomy may be performed. The KBNI neurosurgeons utilize minimally invasive spine surgery techniques when appropriate.
The Kraus Back and Neck Institute (KBNI) in Houston TX takes care of patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.
Patients suffering from a cervical stenosis or lumbar stenosis, or who have been told they may require a lumbar laminectomy or cervical laminectomy, can
contact the Kraus Back and Neck Institute at
……. Or visit www.SpineHealth.com to schedule an appointment online
Keywords: laminectomy, lumbar laminectomy, cervical laminectomy, lumbar stenosis, cervical stenosis, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin