A laminectomy removes the bony posterior arch of one or more vertebrae protecting the spinal cord; this decompresses the spinal cord and nerve roots by widening the space around the nerves, relieving symptoms and in some cases preventing paralysis. The most common reason for laminectomy is repair of a prolapsed or herniated intervertebral disk.
Herniated Disk
Six to twelve weeks conservative treatment of a herniated disk includes avoiding painful positions and following an exercise and pain-medication regimen relieves symptoms in 90 percent of people with a herniated disk, according to the American Academy of Orthopaedic Surgeons.
In approximately 10 percent of patients, medication and physical therapy fail to improve symptoms such as sharp back pain that shoots down the leg, weakening of the leg muscles and loss of sensation in the leg and foot, then laminectomy relieves the pressure. The herniated disk may occur at the level of the cervical, thoracic or lumbar spine.
Lumbar Spinal Stenosis
"Harrison's Principles of Internal Medicine" says that lumbar spinal stenosis refers to a narrowed spinal canal. According to AAFP.org, as stated by Jamie Alvarez, M.D., lumbar spinal stenosis commonly affects middle-aged and elderly patients.
Symptoms of spinal stenosis may include: back, buttock and leg pain made worse by walking or standing and relieved by sitting. Typically, canal stenosis occurs over several levels, so that the surgeon performs multilevel decompressive laminectomies. Mayoclinic.com says that laminectomy decreases symptoms in 60 to 90 percent of patients with spinal stenosis.
Spinal Epidural Abscess
Symptoms of spinal epidural abscess include the triad of fever, aching back pain and rapidly progressive weakness, states "Harrison's Principles of Internal Medicine."
Risk factors include: diabetes, alcoholism and intravenous drug abuse. Skin infections that spread to the spinal canal through the bloodsteam account for approximately two-thirds of epidural abscesses. Staphylococcus aureus, an organism found on skin, most commonly causes epidural abscess.
Epidural abscess may involve multiple spinal levels, sometimes requiring as many as seven, or more laminectomies. Urgent spinal decompression plus intravenous antibiotics prevents paralysis.
Tumor
Jong-Eun Sim, M.D. in the "Journal of Korean Neurological Society," states that spinal cord tumors have an incidence of 10 per 100,000 people. The most common spinal cord tumors involve the nerve sheath, like schwannoma and neurofibroma. Laminectomy allows removal of these tumors.
References
- Harrison's Principles of Internal Medicine; Dennis Kasper, M.D.; 2005
- Journal of Korean Neurological Society: Removal of intradural-extramedullary spinal cord tumors with unilateral limited laminectomy
- aafp.org: Lumbar Spine Stenosis: A Common Cause of Back and Leg Pain
- MayoClinic.com: Laminectomy
