According to an article on the New York Times website, lumbar spinal surgery is used to correct problems with the vertebrae, discs or nerves of the lower back. The Spine Health website says there are two principal types of lumbar spine surgery: decompression and spinal fusion. Spinal decompression surgery may help relieve pressure on a nerve root--an offshoot of the spinal cord--and spinal fusion surgery is performed to immobilize a painful vertebral segment.
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Laminectomy, also known as decompression, is a type of lumbar spine surgery. According to MayoClinic.com, laminectomy involves the removal of the lamina, which is situated at the back of the vertebra and forms part of the spinal canal's protective ring. MayoClinic.com says laminectomies are performed to enlarge the spinal canal and relieve pressure on the spinal cord or nerve roots caused by spinal stenosis, or narrowing of the spinal canal. Laminectomy may also be used to help alleviate herniated disc-related pain in the lumbar spine, as sometimes the bone or lamina overlying the disc must be removed in order to remove the disc material impinging on a spinal nerve root. The Spine Health website says laminectomy is not necessary for everyone who has spinal stenosis, and that laminectomy typically is used when conservative treatment methods have been unable to relieve symptoms, or when symptoms are severe.
According to the Spine Health website, a microdiscectomy is performed to alleviate the unfavorable health effects of a herniated lumbar disc--the protrusion of disc material into the spinal canal--but is more effective in treating leg pain or radiculopathy than lower back pain. The Spine Health website says that in a microdiscectomy spine surgery, small amounts of bone and intervertebral disc material are removed to relieve nerve root impingement and allow more room in the spinal canal and intervertebral foramen for the nerve to heal. According to the Spine Universe website, during microdiscectomy surgery, various tools are used to excise parts of the ruptured disc. No attempt is made to remove the entire disc at the affected level, as the disc is essential for supporting the adjacent vertebrae. After excision of the offending disc material, the hole created by surgery fills in on its own.
Spinal fusion surgery is a common type of lumbar surgery. According to the Texas Back Institute, posterior lumbar fusion or PLF is a surgical procedure in which the posterior or back aspect of the lumbar vertebrae are fused to improve spinal stability and reduce symptomatic low back pain. During PLF, the spinal surgeon makes an incision in the lower back, through the muscles and connective tissue, to access the lumbar spine. The Texas Back Institute says bone grafts are then placed along the edges of the posterior parts of the involved vertebrae, and pedicle screws are inserted in the vertebral bodies and connected with rods to bolster spinal stability. PLF surgery is used to treat the following conditions: spondylolisthesis or the forward displacement of a vertebra or series of vertebrae relative to the vertebrae below, spinal deformity and spinal stenosis. PLF surgery is also used with patients who have already had low back surgery.