Laminectomy is the traditional operating method for the decompression of spinal canal stenosis. New partial decompression processes have been suggested in the treatment of lumbar stenosis. The benefit of a micro surgical approach is the chance of an extensive bilateral decompression of the spinal canal or foramen at one or numerous levels, through a minimal para-spinal muscular separation.
Spinal stenosis is one of the most common age-related back problems. And it isn’t pleasant. It usually results from years of osteoarthritis, a thickening of the body’s ligaments that connect the bones to the spine and a deterioration of the cushioning between disks in the vertebrae all of which cause the spinal canal to narrow. As a result, nerves that travel down to the legs can become pinched near the bottom of the spine, causing pain and an inability to walk properly.
The condition affects 8 to 11 percent of Americans, mostly those over age 50, according to the American Academy of Orthopedic Surgeons.
The telltale symptoms of spinal stenosis are numbness, weakness and cramping or pain in the legs, thighs or feet, which interferes with the ability to walk. While symptoms of spinal stenosis start slowly and tend to worsen over time, leg pain can become so severe that sufferers find themselves unable to stand or walk for more than a few minutes.
Spinal stenosis doesn’t really cause back pain but pain that radiates down into buttocks and lower legs. The narrowing of the spinal canal reduces blood flow to nerves in the lower back. The pain often diminishes or disappears altogether when a patient is sitting or lying down unlike a pinched nerve caused by a bulging disk, which may hurt all the time.
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During the first few weeks or months at home, exercises and activity restrictions must be followed. The at-home exercises are usually provided by the treating physical therapist. A few at-home procedures post-surgery are:
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Laminectomy enlarges your spinal canal to relieve pressure on the spinal cord or nerves, and has about an 80 percent success rate at improving walking abilities. There is no cure for spinal stenosis, but there are treatments to help relieve symptoms. successful results of surgery were achieved in 86.7% of patients with lumbar stenosis, 77.6% of patients with lumbar stenosis with herniated disc, and 63.6% of patients with lateral recess stenosis. Successful results of surgery for lumbar stenosis declined to 69.6% by 1 year postoperatively.
Laminectomy is a common but major surgery with significant risks and potential complications. You may have less invasive treatment options available. Consider getting a second opinion about all of your treatment choices before having a laminectomy.
It depends on the extent of your surgery and your situation. After a minor (decompressive) laminectomy, you can usually able do desk work and light housekeeping within a few days to a few weeks. If you also had spinal fusion, your recovery time will likely be longer, 2-4 months. You may not be able to lift and bend for 2-3 months. Start light walking for exercise and physical therapy exercises as soon as your doctor says you're ready. This will help speed your recovery. You may not know if your back pain is better until 6 weeks or more after the surgery.
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A well-known complication of lumbar laminectomy is excessive shear displacement in the intervertebral joint, leading to postoperative spondylolysis or spondylolisthesis. In most cases, the degree of bone, ligament or facet joint removal will not significantly affect the strength of the spine. However, depending on the amount of tissue removal and whether the spine has been weakened by arthritis, degenerative changes or previous surgery, the strength of the spine may be compromised.
Years after decompression (lumbar laminectomy), lumbar stenosis can come back (the bone can grow back) at the same level, or a new level can become stenotic and cause back pain or leg pain. Pain that is relieved right after surgery but then returns abruptly is often due to a recurrent lumbar disc herniation.
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