Decompressive laminectomy for spinal stenosis

Decompressive laminectomy is the most common type of surgery done to treat spinal stenosis. This surgery is done to relieve pressure on the spinal cord or spinal nerve roots caused by age-related changes in the spine and to treat other conditions, such as injuries to the spine, herniated discs, or tumors. In many cases, reducing pressure on the nerve roots can relieve pain and allow you to resume normal daily activities.

Laminectomy removes bone (parts of the vertebrae) and/or thickened tissue that is narrowing the spinal canal and squeezing the spinal cord and nerve roots. This procedure is done by surgically cutting into the back.

In some cases, spinal fusion (arthrodesis) may be done at the same time to help stabilize sections of the spine treated with decompressive laminectomy. Spinal fusion is major surgery, usually lasting several hours. There are different methods of spinal fusion:

• In the most common method, bone is taken from elsewhere in your body or obtained from a bone bank. This bone is used to make a "bridge" between adjacent spinal bones (vertebrae). This "living" bone graft stimulates the growth of new bone.
• In some cases an additional fusion method (called instrumented fusion) is performed, in which metal implants (such as rods, hooks, wires, plates, or screws) are secured to the vertebrae to hold them together until new bone grows between them.

There are a variety of specialized techniques that can be used in spinal fusion, although the basic procedure is the same. Techniques vary from what type of bone or metal implants are used to whether the surgery is done from the front (anterior) or back (posterior) of the body. The method chosen will depend on a number of factors, including your age and health condition, the location (lower back or neck [cervical]) of stenosis, the severity of nerve root pressure and associated symptoms, and the surgeon's experience. Spinal fusion increases the possibility of complications and the recovery time after surgery.

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