Decompressive Laminectomy:

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.

• Symptoms are so severe that you are unable to perform normal daily activities and your quality of life is affected.
• The symptoms become more severe and intolerable over time.
• Most spinal stenosis occurs in the lower (lumbar) back. If you have stenosis in the neck (cervical) area, your health professional may recommend surgery to prevent worsening of the condition, which can cause nerve damage and paralysis.

• Spinal stenosis develops in another area of the spine.
• An earlier surgical procedure was not effective in controlling symptoms.
• Instability develops, or fusion does not occur.
• Regrowth of tissue (lamina) presses on the spinal cord or spinal nerve roots.
• Spinal fusion may be done at the same time as decompressive laminectomy. Spinal fusion may help to stabilize sections of the spine that have been treated with decompressive laminectomy. Some studies suggest it may also improve function over time and relieve pain.

• Problems from having general anesthesia.
• A deep infection in the surgical wound.
• A skin infection.
• Blood clots in the deep leg or pelvic veins (deep vein thrombosis), which rarely travel to the lungs (pulmonary embolism).
• An unstable spine (more common after multiple laminectomies are done without using spinal fusion).
• Nerve injury, including weakness, numbness, or paralysis.
• Tears in the fibrous tissue that covers the spinal cord and the nerve near the spinal cord, sometimes requiring reoperation.
• Difficulty passing urine or loss of bladder or bowel control.
• Death (rare) related to major surgery.
• If you have diabetes or heart disease or are a smoker, you may be at greater risk for complications.