Minimally Invasive Micro-laminectomy procedure for Lumbar decompresses low back nerves – on Outdoor Patients

Your spine surgeon or Spine doctor may recommend a laminectomy if you have low back or leg pain that has not responded to nonsurgical treatments such as medication or physical therapy. Lumbar Laminectomy surgery

Lumbar laminectomy, a common spine procedure, is performed to relieve pressure on specific nerves that cause leg and low back pain. The idea is to make more room for the nerves which in-turn causes relief from back pain , leg pain and improves walking.

Lumbar decompression or laminectomy now can be performed with several techniques. We have the time tested open lumbar decompressions and laminectomies to the newer evolved techniques of minimally invasive , microscopic or endoscopic decompressions which allows for a quicker recovery period

Minimally invasive spine surgery has many benefits.

✓ Smaller incision(s)

✓ There is less blood loss

✓ There is a lower risk of soft-tissue and muscle damage

✓ There is a lower risk of infection

✓ Post-operative pain is less

✓ Use of pain medication is reduced

✓ Recovery is faster

What happens during the Lumbar Laminectomy surgery?

The surgery involves removal of a small amount of the lamina, which is a thin bone covering the spinal canal. It may include the removal of bony overgrowths (ie. osteophytes) or ligament tissue that compress spinal nerves at one or multiple levels.

A minimally invasive lumbar surgery (MISS), is similar to open lumbar spine surgeries except the surgeon uses surgical instruments that are specifically designed for MIS surgery. These instruments are small enough to allow the surgeon instead of cutting soft tissues. This results in less pain after surgery, fewer tissues to heal and a faster recovery.

A small incision is made (almost puncture-like) about 1 inch over the area of the lower back to which the surgery will be performed. The Spine Surgeon then slides a series of small retractors through his incision to separate soft tissues (eg muscles). The tissue is held apart by the retractor. The surgeon may wear special eyeglasses (loupes), or a surgical microscope that allows him/her to see the surgical field in microscopic detail. Because the loupes or microscopes can magnify and illuminate, surgeons are able to see tiny tissues that could be compressing spinal cords. Bone drills and other specially-designed instruments for MISS can be used to remove bone spurs, i.e. osteophytes, or ligament tissue that causes nerve compression, while also conserving the lamina, and sometimes the interspinous, ligament.

The surgeon will then remove the retractors, allowing the soft tissue to return to their original positions after the procedure. The sutures dissolve in 2-4 weeks and close the small incision.

Surgery usually takes about an hour and is done under general anaesthesia. Age is no bar as long as patient is fit for anaesthesia.

Who will benefit from this procedure ?

➢ Degenerative disc disease

➢ Lumbar herniated disc

➢ Lumbar spinal stenosis

➢ Lumbar synovial cyst

Patients with these conditions who have back pain radiating to the legs with tingling or numbness causing difficulty in walking , not improving with medications and physiotherapy, will benefit from the procedure.

What to expect in the post surgical period?

Typically patients start walking the same day or next day after surgery. They remain in the hospital for about 2 days during which they are independently walking , climbing stairs, going to the washroom etc. A check dressing is done after which they are discharged. There is no bed rest period post surgery. Once back home it takes around a week to feel completely normal , and a week for the wound to dry after which they can start stepping outside and living a normal life.

Before going for surgery , discuss all possible risks and benefits with your surgeon. He is the best person to help you decide if the procedure is for you.

— Dr. Priyank Patel , Consultant Spine Surgeon in Mumbai , attached to several Corporate Hospitals across Mumbai and thane . Co-Founder WeAreSpine , a spine practice group.