Laminectomy

About Laminectomy

Laminectomy removes the lamina posterior bony arch of the vertebra to decompress the spinal canal, treating spinal stenosis most common indication in elderly, herniated disc, spinal tumor, infection, or trauma. Lumbar laminectomy for spinal stenosis is one of the most common spine surgeries. The procedure involves a midline incision, separation of paraspinal muscles, identification of the lamina, removal of bone using rongeurs and Kerrison punches, and decompression of the thecal sac and nerve roots. Foraminotomy enlarges the neural foramen if nerve root compression exists. Fusion is added if instability is present or created by extensive bone removal. Minimally invasive laminectomy uses tubular retractors through small incisions, reducing muscle damage and hospital stay. Microdecompression preserves the midline structures, reducing postoperative instability. Complications include dural tear with cerebrospinal fluid leak, nerve root injury, epidural hematoma, infection, and degeneration of adjacent segments particularly after fusion. Randomized trials comparing decompression alone with decompression plus fusion for degenerative spondylolisthesis have reached differing conclusions, and the choice depends on the degree of instability.