Part 1: Understanding Lumbar Pain and Anatomy
Lumbar laminectomy is a surgical procedure most often performed to treat leg pain related to herniated discs, spinal stenosis, and other related conditions. Stenosis occurs as people age and the ligaments of the spine thicken and harden, discs bulge, bones and joints enlarge, and bone spurs or osteophytes form. Spondylolisthesis (the slipping of one vertebra onto another) also can lead to compression.
The goal of a laminectomy is to relieve pressure on the spinal cord or spinal nerve by widening the spinal canal. This is done by removing or trimming the lamina (roof) of the vertebrae to create more space for the nerves. A surgeon may perform a laminectomy with or without fusing vertebrae or removing part of a disc. Various devices (like screws or rods) may be used to enhance the ability to obtain a solid fusion and support unstable areas of the spine.
Spinal Anatomy 101
The human spine extends from the skull to the pelvis. It is made up of individual bones called vertebrae. The vertebrae, stacked on top of each other, are grouped into four regions:
1) the cervical spine or neck (7 vertebrae)
2) the thoracic spine or chest area (12 vertebrae)
3) the lumbar spine or low back (5 vertebrae)
4) the sacrum or pelvis area (5 fused, nonseparated vertebrae)
The base of the spine, the coccyx (or tailbone), includes partially fused vertebrae and is mobile.
The vertebrae are separated from one another by soft pads, called intervertebral discs, which allow the spine to bend and flex and act as shock absorbers during regular activity. These discs also prevent the vertebrae from rubbing against each other. Each disc is made up of two parts, a soft center called the nucleus and a tough outer band called the annulus.
Throughout the length of the spine is a central tube, surrounded by bone and discs, which is your spinal canal. Inside the spinal canal are the spinal cord, the cauda equina, and spinal nerves. The spinal cord begins at the base of the brain and ends in the lumbar spine area in a bundle of nerves called the cauda equina. A pair of spinal nerves branch out (one to the left and one to the right) at each vertebral level. These provide sensation and movement to all parts of the body.
A lumbar laminectomy may be necessary to relieve pressure on the spinal canal.