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What is a LumbarLaminectomy/Laminotomy?The lumbar area o the spine is better knownas the lower back. The lamina is a part o eachvertebra. A lumbar laminectomy is the surgicalremoval o the lamina or part o the laminaon one or more o the vertebrae in the lowerback. This is usually done to relieve pressureon nerves that may become inamed rom pressurecaused by a narrowed spinal canal, bonespurs, or a herniated disc. Once the lamina isremoved, the surgeon can then access thespinal canal and remove the source o irritationor pressure.

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Who is a Candidate forthis Surgery?Those who suer rom requent lower back painand perhaps leg pain and numbness may have acondition known as spinal stenosis. Spinal stenosisdescribes the narrowing o the spinal canal in thearea where the nerves and nerve roots exit thespinal column. This narrowing can occur as a result

o arthritis in the spine, by calcium deposits, or bythe wear and tear that occurs rom repetitive stresson the lower spine. In addition, some people areborn with a narrow spinal canal that becomessymptomatic as they age.

The narrowing o the spinal canal may eventuallycause pressure on the nerves and nerve roots thatemerge rom the spinal column. This irritation canresult in pain and numbness, particularly ater sittingor standing or extended lengths o time. Lumbarlaminectomy may be suggested in order to make

more room or the nerves or nerve roots.

Another condition that is oten treated with lumbarlaminectomy is a herniated disc. The discs actas cushions or shock absorbers between thevertebrae. Part o the disc may herniate or bulge intothe canal, causing pressure to the nerves. Once thelaminectomy is perormed, the surgeon may then trimor remove whatever material is causing the irritation.

What are the

Alternatives?Surgery is usually the last option considered. I

your symptoms are mild, you may not require anytreatment at all. Other conservative treatmentssuch as physical therapy, medications and steroidinjections may relieve symptoms or a time; howeverthey usually do not permanently change theunderlying cause o the problem the narrowing othe spinal canal. In some cases, lumbar laminectomymay be the only solution.

How Long is theHospital Stay?The time spent in the hospital ater a laminectomydepends on several actors including youroverall health and the extent o your particularsurgery. Many people will return home aterone to three days in the hospital.

How Long Will it Take toRecover?Recovery time ater lumbar laminectomy variesdepending on your particular situation, the numbero levels involved, as well as your generalhealth. Key to a successul recovery is maintaininga positive attitude. You will be able to takeshort walks while in the hospital, and need togradually increase the distance and requencyo your walks once at home. Avoid standing or

sitting or prolonged periods and change yourposition requently to help minimize back spasmsand discomort. Your doctor will give you specifcinstructions on activity levels, including when youcan resume driving and return to work.

What if I Have OtherQuestions?Were happy to answer any questions you may have.Call Gina Lambert, the spine care coordinator, at

689-5763.

How are Back ProblemsEvaluated?Your doctor will use a number o approaches toevaluate and diagnose back problems such as spinalstenosis or a herniated disc. These include:

A detailed history: Your doctor will needto know where and when it hurts, i there was

a recent injury or all, as well as a descriptiono the pain. Are there positions or activities thatmake it eel worse? What makes it eel better?

A physical exam: Once your history is given,a thorough exam by a spine expert is anotherimportant step in getting a good diagnosis.

Diagnostic Imaging: X-rays can show thestructure and alignment o the vertebrae as wellas the presence and size o bone spurs or otherbony abnormalities.

CT or Computerized Tomography: Ratherthan a single X-ray, a CT scanner sends out

a number o beams at dierent angles. Theseimages are then read by a computer, producingdetailed cross-sections or slices that can showthe shape and size o the spinal canal and thesurrounding structures.

MRI or Magnetic Resonance Imaging:This uses a very powerul magnet to send radiowaves into the body. The images produced arevery helpul in visualizing the sot tissues suchas the spinal cord itsel, as well as the discs andnerve roots.

Bone Scans: are useul in revealingabnormalities such as inections, ractures,tumors and arthritis. Because bone scans areunable to dierentiate between these problems,they are usually perormed in conjunctionwith other diagnostic tests.

To schedule an appointment with a spinespecialist, call 540-689-5500.