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A laminectomy is a surgical incision into the vertebra to obtain access to the spinal cord. The main purpose of this operation is to relieve pain caused by tumors or herniated intervertebral discs, or to relieve pressure on a spinal nerve.

Unfortunately this operation isn’t always successful. Laminectomy is very effective in decreasing the pain and improving the function in patients with lumbarspinalstenosis, a condition that primarily afflicts elderly patients, and is caused by degenerative changes that result in enlargement of the facet joints. The enlarged joints then place pressure on the nerves which can be effectively relieved with a lumbar laminectomy.

Anatomy of the back

Human spine is made up of individual bones called vertebrae, which are stacked on top of each other and are grouped into four regions:

1.    the cervical spine or neck (made up of 7 vertebrae)
2.    the thoracic spine or chest area (made up of 12 vertebrae)
3.    the lumbar spine or low back (made up of 5 vertebrae)
4.    the sacrum or pelvis area (made up of 5 fused, non-separated vertebrae)

The vertebrae are separated from one another by soft pads called intervertebral discs, which prevent the vertebrae from rubbing against each other. Each disc is made up of two parts, a soft center called the nucleus and a tough outer band called the annulus. Inside the spine is a central tube, surrounded by bone and discs, called the spinal canal which is filled with spinal cord, the cauda equina, and spinal nerves. 

The most common cause – herniated intervertebral disc

One of the most common reasons for laminectomy is a prolapsed or herniated intervertebral disc.

This happens when disc comes out from its normal localization and causes pressure on spinal cord or surrounding nerves. Consequences are different depending on the localization of herniation. If the herniated disc is in the lumbar region, this can cause:

  • sharp and continuing back pain
  • a weakening of the muscles in the leg
  • some loss of sensation in the leg and foot
  • difficulties to raise your leg when it is held in a straight position

A herniated disc in the neck region can cause symptoms including:

  • pain in arm or shoulder
  • numbness and weakness in the arm

A herniated disc may be triggered by, for example, twisting your back while lifting something heavy.

Spinal stenosis

Spinal stenosis is a specific condition characterized by a narrowing of spaces in the spine which is often resolved by laminectomy. This narrowing results in pressure on the spinal cord and nerve roots which can lead to a number of problems, depending on which nerves are affected. In great majority of patients, spinal stenosis is accompanied with cramping, pain or numbness in legs, back, neck, shoulders or arms; a loss of sensation in extremities; and sometimes problems with bladder or bowel function. In most cases mild symptoms of spinal stenosis are removed by pain relievers, physical therapy or a supportive brace. However, if we talk about some more serious cases of spinal stenosis, doctors may recommend surgery.

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