Minimally Invasive

Lumbar Laminectomy

Lumbar Spinal Stenosis & Keyhole
Decompression / Laminectomy.
Lumbar spinal stenosis is the most common condition leading to spine surgery for patients over the age of 60. Usually a result of the “wear-and-tear” changes in an individual’s spine that occur naturally with age, spinal stenosis of the lumbar spine typically produces pain, cramping, numbness, weakness and/or a pins-and-needles feeling in the legs that is worse with walking and better with resting or leaning forward. The patient may also experience low back pain and/or hip pain along with activity-related leg discomfort, called "neurogenic claudication".
Conservative treatment options that may help with spinal stenosis prior to considering surgery include:
  • stabilisation "core" exercises.
  • stretching and strengthening exercises.
  • cortisone injections.
  • non-steroidal anti-inflammatory drugs (NSAIDS) or a course of oral steroids.
  • training on how to safely use your back (such as proper lifting techniques).
  • physiotherapy & hydrotherapy.
  • switching to ergonomic furniture.
  • referal to a pain management clinic
A laminectomy is typically performed to alleviate pain caused by nerve impingement that can result from spinal stenosis. The surgery involves a keyhole approach through the skin and muscle to reach the spine, then removing a small portion of the bone and/or joint / disc material around the nerves to allow more space so that the nerves can recover and return to normal function. Following surgery for nerve compression and stenosis, sometimes the nerves do not recover despite an adequate decompression. The operation is performed via a small incision on your back under a general anasthetic and takes upto several hours.
Following laminectomy surgery, patients are in hospital for one to three days, and the individual patient's activity is largely dependent on his/her pre-operative health and age. Patients are encouraged to walk directly following a laminectomy. It is recommended that patients avoid excessive bending, lifting, or twisting for six weeks after the surgery. The success rate of a lumbar laminectomy to alleviate pain from stenosis is generally favorable with over 80% of patients experiencing significant improvement in their function (ability to perform normal daily activities) and markedly reduced levels of pain and discomfort associated with spinal stenosis.
Rehabiliation following a Laminectomy may include the following:
1. Plenty of walking! This is a great low implact activity.
2. Hydrotherapy. Walking / aqua-therapy / swimming laps are all of benefit.
3. Physical therapy / Physio. The focus here is on "core" strengthening to support your spine and reduce the risk of recurrence.
4. Stopping smoking. The toxins from cigarette smoke damage the disks in the spine.
5. Focus on good general health, weight limitation and diet.
The potential risks and complications with a lumbar laminectomy include:
  • Nerve root damage (1 in 1,000).
  • Cerebrospinal fluid leak (1% of the time). If the nerve sac is breached, a spinal fluid link may be encountered but does not change the outcome of the surgery. Generally a patient needs to lie down for about 24 hours to allow the leak to seal.
  • Infections (less than 0.5%).
  • Bleeding. While possible, this complication is uncommon and usually related to anticoagulant medication that the patient takes.
  • Postoperative instability of the operated level (less than 5 % ). The natural progress of spinal degeneration may lead to a "spondylolisthesis" with slippage of the bones of the spine requiring a fusion, through the front (ALIF) or the back (TLIF) of the spine.
MIS Minimally Invasive Laminectomy Dr Ralph Mobbs Neurosurgeon
  • Spinal Stenosis 1
    Spinal Stenosis 1
  • Spinal Stenosis 2Arrows show spinal compression
  • Keywhole Approach for Surgery
  • Minimally Invasive Tumour Resection
  • Results of Minimally Invasive Laminectomy
    • Dr Mobbs
  • Prince of Wales Private Hospital
  • Keyhole Approach
  • Minimally Invasive Laminectomy
  • Results of MIS Surgery 1
  • Results of MIS Surgery 2
General anesthetic complications such as a heart attack, blood clots, stroke, pneumonia, or pulmonary embolism can happen with a lumbar laminectomy as with any surgery. Although in the general population these complications are rare, laminectomy surgery for spinal stenosis is generally done for elderly patients and therefore the risk of general anesthetic complications is somewhat higher.
For appointments with Dr Ralph Mobbs at the NeuroSpineClinic, please contact 02 9650 4766, or visit the webpage: www.neurospineclinic.com.au
Created By NeuroSpineClinic & Dr Ralph Mobbs02 9650 4766