http://www.medilaw.tv Lumbar Spine Laminectomy courtroom videos. Illustrates the surgical technique for performing a lumbar laminectomy. This procedure is used to decompress the spinal cord and spinal nerves. Also shown is the patient position, skin preparation and incision, the surgical approach, the lamina being removed and lateral recesses being enlarged and finally wound closure.
Spinal stenosis is a condition where disc, bone and ligament are narrowing the space in the spinal canal where the spinal nerves reside, causing symptoms.
A laminectomy removes bone and ligament to make more space for the spinal nerves. A lumbar laminectomy is done to improve the leg symptoms, not to improve back pain.
INDICATIONS
A lumbar laminectomy is performed for spinal stenosis, to relieve leg pain that has not improved with conservative treatment.
ALTERNATIVES
Surgery is the only treatment alternative that will relieve the compression of the nerves.
Spinal stenosis is not life-threatening, so surgery is always optional.
However the back pain can be decreased by
weight loss
walking
pain-relieving medication
physical therapy
hydrotherapy
epidural steroid injections, and
avoiding bending, lifting, twisting and prolonged sitting.
Lumbar Spine Laminectomy courtroom videos.
If the spinal stenosis is compressing the spinal cord and causing neurological symptoms (myelopathy), then your surgeon will usually recommend surgery to decompress the spinal cord and relieve the neurological symptoms (paresthesia, numbness, weakness). Surgery may or may not relieve any back pain. A laminectomy is a good option, especially if the spinal compression is over multiple vertebral levels.
GOALS
A laminectomy is performed with the aim of removing the vertebral lamina and decreasing the compression on the spinal cord and nerve roots.
TECHNIQUE
You will be placed in a kneeling position. Your skin will be cleaned. An incision will be made in the middle of the back. The overlying muscles will be moved to the sides. Your surgeon will confirm the correct vertebrae for the procedure by using x-ray imaging. The spinous processes will be removed. The ligamentum flavum is then separated from the lamina. The lamina is removed at each level needing to be decompressed. The remaining ligamentum flavum are removed. If the nerve is still compressed in the vertebral foramen, portions of this tunnel are removed. The disc is examined to ensure there are no bulges compressing the nerve. The muscles are replaced, and the wound is closed with sutures. Lumbar Spine Laminectomy courtroom videos.
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