Our Summary

Fusion is a common surgical procedure for a variety of spinal issues. However, it can lead to increased deterioration in the surrounding areas of the spine. To combat this, certain surgical methods that aim to preserve movement have been developed. These include total disc replacement, laminoplasty, interspinous implants, and dynamic posterior stabilization systems.

While these methods initially generated excitement, there have been concerns about their effectiveness. Total disc replacement, for example, is mainly used for degenerative disc disease, but there are many conditions that make it unsuitable, making it difficult to find the right patients for this treatment.

Interspinous implants have shown promise in treating spinal stenosis (a narrowing of the spaces within your spine), but more research is needed to determine the extent of stenosis these implants can treat.

Laminoplasty, a surgical procedure that creates more space for the spinal cord and nerve roots, has shown to have fewer complications and more benefits compared to fusion and laminectomy (surgical removal of part of a vertebral bone called the lamina) in patients with cervical myelopathy/radiculopathy (compression of the spinal cord and nerve roots).

Lastly, dynamic posterior stabilization, a surgical procedure that stabilizes the spine while preserving some movement, could potentially replace traditional fusion in some cases. However, this method is only successful in mild to moderate cases.

FAQs

  1. What are the main indications for total disc replacement?
  2. What are some of the benefits of laminoplasty in patients with cervical myelopathy/radiculopathy?
  3. What are the possible complications of fusion and laminectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about spinal laminectomy is to follow post-operative rehabilitation exercises and physical therapy recommendations to ensure proper healing and to strengthen the muscles supporting the spine. This can help improve overall function and reduce the risk of complications or recurrent issues in the future.

Suitable For

Patients who are typically recommended spinal laminectomy are those with spinal stenosis, herniated discs, spinal cord compression, and other conditions that are causing pressure on the spinal cord or nerves. These patients may be experiencing symptoms such as back pain, leg pain, numbness, weakness, or difficulty walking. Spinal laminectomy may be recommended when conservative treatments such as physical therapy, medications, or injections have not provided relief. It is important for patients to consult with a spine specialist to determine if spinal laminectomy is the best treatment option for their specific condition.

Timeline

Before spinal laminectomy:

  • Patient experiences symptoms such as back pain, leg pain, numbness, tingling, and weakness due to spinal stenosis, herniated disc, or other spinal conditions
  • Patient undergoes diagnostic tests such as X-rays, MRI, and CT scans to determine the cause of their symptoms
  • Patient may undergo conservative treatments such as physical therapy, medications, and injections to manage their symptoms
  • If conservative treatments are ineffective, patient may be recommended for spinal laminectomy surgery

After spinal laminectomy:

  • Patient undergoes spinal laminectomy surgery to relieve pressure on the spinal cord or nerves
  • Recovery period involves pain management, physical therapy, and restrictions on activities to allow proper healing
  • Patient may experience improvement in symptoms such as reduced pain, improved mobility, and increased strength
  • Long-term follow-up care may be necessary to monitor for any complications or recurrence of symptoms
  • Patient may be able to resume normal activities and enjoy improved quality of life following successful spinal laminectomy surgery.

What to Ask Your Doctor

  1. What is the purpose of a spinal laminectomy procedure?
  2. What are the potential risks and complications associated with spinal laminectomy?
  3. What is the expected recovery time after a spinal laminectomy?
  4. Will I need physical therapy or rehabilitation after the procedure?
  5. Are there any alternative treatments or procedures that could be considered instead of a spinal laminectomy?
  6. How long do the effects of a spinal laminectomy typically last?
  7. How will a spinal laminectomy impact my daily activities and lifestyle?
  8. What are the success rates of spinal laminectomy in patients with similar conditions?
  9. How often do patients experience adjacent level disease or other complications after undergoing a spinal laminectomy?
  10. Are there any specific post-operative care instructions or restrictions that I should be aware of?

Reference

Authors: Gelalis ID, Papadopoulos DV, Giannoulis DK, Tsantes AG, Korompilias AV. Journal: Eur J Orthop Surg Traumatol. 2018 Apr;28(3):335-342. doi: 10.1007/s00590-017-2052-3. Epub 2017 Oct 6. PMID: 28986691