The Surgeon’s Role
Your surgeon will:
- review your neurological history and examination;
- review your diagnostic tests;
- plan a surgical approach; and
- review the procedure with you.
You must have a thorough understanding of the diagnosis (what is causing your back or leg symptoms) and the risks and benefits of the proposed surgery. Once you are confident that surgery is the correct option for you, turn your thoughts to the future and the recovery process
Beginning the Operation
In the operating room, a decompressive lumbar laminectomy begins with an incision in your lower back (Fig. 6). Through this opening, your surgeon will reach the area where your cauda equina and/or spinal nerve(s) are being pinched.
Reaching the Pinched Nerve
After the incision is made, the surgeon will use a retractor to pull aside fat and muscle until the vertebra is exposed. A fine drill is then used to remove a section of the vertebra (dotted lines in Figs. 7,above & 8). Next, an opening is cut in the ligamentum flavum through which the spinal canal can be reached.
Removing the Cause of Pressure
Once the spinal nerve root(s) and cauda equina have been exposed, the surgeon will use a fine drill to remove bone spurs or rough edges of the intervertebral disc (Fig. 9). This will make the openings of the foramen and the spinal canal larger and help to relieve pressure on your spinal nerves (Fig. 10,next page).
Fusion And Instrumentation
On some occasions it may be necessary to stop the movement between two adjacent vertebrae. This is called a fusion. Your surgeon will place bone graft chips between the vertebrae to create a solid section of bone which prevents the motion. The surgeon may also elect to use metal implants (Fig. 11) to prevent any motion while the bone graft hardens.
Closing the Incision
The operation is completed when each layer of the incision closed with suture material (stitches) or surgical staples. If the outer incision is closed with staples or non-absorbable sutures, they will have to be removed after the incision has healed.