Decompression Posterior & Fusion Spine (Level II)

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Overview

Spinal stenosis occurs when there is compression of the spinal cord in the neck or the spinal nerve roots of the lower back. There are many causes of spinal stenosis including aging, arthritis, hereditary, a tumour of the spine, spondylolisthesis and trauma. The symptoms of lumbar stenosis are leg pain (sciatica) and weakness, leg tingling, or numbness. The typical symptom of cervical spinal stenosis is arm pain.

Decompression Posterior & Fusion Spine options

  • The treatment include non-surgical options such as anti-inflammatory medication, exercise, epidural injections) or back surgery.
  • Surgical treatmentThe aim of spinal stenosis is to decompress the spinal cord permanently.

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Before the Treatment

How should I prepare for the Decompression Posterior & Fusion Spine?

You should quit smoking before the surgery and exercise regularly to improve the recovery rate. Before taking any medication or an herbal remedy, it is better to discuss it with the physician.

How it is Performed

Laminectomy: Surgery for Back Pain

It is a surgical procedure used to reduce pressure on the nerve roots by removing the lamina, the flattened sections at the back of the vertebral arch. The vertebral arch is the bone that joins the vertebral body surrounding the spinal cord.

Procedure

The procedure requires general anesthesia or spinal anaesthesia. For lumbar laminectomy surgery, the patient is made to lie with face down or placed in a kneeling position. An incision is made in the  lower back region and separates the muscle to gain access to the lamina. To reach the affected nerve roots, some part of one or more vertebrae is removed. The surgeon then removes the lamina or any bony growths or ruptured disc material to reduce the pressure on the spinal cord and nerves. This surgical procedure takes about 1 to 2 hours.

Recovery

Risks and complications of laminectomy- The complications that are possible after laminectomy are:

  • Bleeding
  • Infection
  • Blood clots
  • Nerve damage
  • Spinal fluid leak
  • Bowel or bladder incontinence
  • Worsening of back pain

 

Alternate surgical methods

Foraminotomy- In this procedure, the surgeon cuts away bone at the sides of vertebrae. This widens the space where nerve roots leave the spine. This space enlargement reduces pressure on the nerves and helps in relieving pain.

Foraminotomy can sometimes reduce the stability of the spine, similar to that happening in a laminectomy. Spinal fusion is required at the same time. It increases the recovery time but also helps prevent the spine from losing its stability. Spine infusion helps to correct problems that occur after a foraminotomy.

Discectomy- A slipped disc or a bulging disc presses the spinal nerve causing pain. In a discectomy procedure, all or part of the disc is removed. A discectomy is done either by large incision or through a small incision using tools from outside the body. A discectomy can be a part of larger surgery such as foraminotomy, laminectomy or spinal fusion.

Disc Replacement- Artificial disc replacement is the removal of damaged spinal disc and insertion of artificial disc between the vertebrae. Disc replacement allows continued motion of the spine. It is an alternative to spinal fusion. The recovery time for a disc replacement is shorter than for a spinal fusion.

Interlaminar Implant- Implantation of a U-shaped device is another alternative to spinal fusion. The device is implanted between two back bones and helps to maintain the space between them. The implant provides stability and does not completely restrict the motion.

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