Decompressive Laminectomy to Cure Sciatica Pain

Sciatica is a prevalent cause of chronic pain around the globe. This nerve condition can diminish your ability to get through the day comfortably and participate in physical activities. 

Surgery may be recommended in persistent cases of sciatica that consistently worsen and won’t respond to non-surgical methods. Decompressive laminectomy is a type of spinal decompression surgery that can cure sciatica pain. 

Here, we’ll discuss how decompressive laminectomy can eradicate sciatica pain and help you overcome chronic nerve pain. 

What is Sciatica?

The sciatic nerve is the biggest nerve in the body. It extends from the lower back to the buttocks and stretches down both legs. If the sciatic nerve is damaged or irritated, sciatica can result. Any instance of pain that starts in the lower back and moves down one or both legs is considered sciatica. 

Sciatica impacts an estimated 10% to 40% of the population. It can be diagnosed with an X-ray, MRI, CT scan, or EMG, along with a full physical exam and medical history. 

Causes of Sciatica

The most frequent cause of sciatica is a slipped disc. Also called a herniated or bulging disc, a slipped disc occurs when a spinal disc tears. The jelly-like interior of the disc can protrude from the tear in the disc’s exterior and press on nearby nerves, including the sciatic nerve in the lumbar spine. 

Other potential causes and risk factors of sciatica include:

  • Improper posture
  • Previous lower back or spine injury
  • The aging process
  • Osteoarthritis 
  • Being overweight
  • Overuse of the lower back
  • Sedentary lifestyle
  • Osteoarthritis
  • Diabetes
  • Nerve disorders 

Sciatica Symptoms

The telltale sign of sciatica is lower back pain that radiates to the buttocks and descends down each leg to the calves. The pain can range from achy to burning to sharp and even “electric”. Oftentimes, sciatica pain worsens after long periods of sitting and even abrupt movements like sneezing or coughing. 

Sciatica symptoms can also include:

  • Tingling, numbness, or weakness in a leg or foot
  • Feeling of pins-and-needles in the leg or foot
  • Lost range of motion in the spine

Spinal Stenosis and Sciatica

Spinal stenosis is a condition defined by the gradual reduction of space in the spinal canal, and it’s a common cause of sciatica pain. Lumbar spinal stenosis is one of the most frequently diagnosed spinal conditions today. 

If spinal stenosis affects the lumbar (lower) spine, it can impact the sciatic nerve and increase the patient’s risk of developing sciatica pain.

How Does Spinal Stenosis Cause Sciatica?

When the spinal canal becomes narrower due to spinal stenosis, the vertebrae can begin to press on nearby nerves. If stenosis occurs in the lumbar spine, which is where the sciatic nerve begins, the vertebrae may place stress on the sciatic nerve. 

The pressure of the narrowed spinal canal on the sciatic nerve can lead to irritation and injury, which can trigger sciatica pain. 

Decompressive Laminectomy

Decompressive laminectomy is a surgical procedure during which the lamina, which comprises the roof of the spinal canal, is taken out of the spine. This creates more room in the spine to combat symptoms of spinal compression. 

One of the main applications of decompressive laminectomy is for sciatica pain induced by spinal stenosis in the lumbar spine. 

How Does Decompressive Laminectomy Help With Sciatica Pain?

When the lamina is removed in decompressive lumbar laminectomy, it creates significantly more space for the spinal nerves and the sciatic nerve. This relieves the pressure on the nerves for relief from pain, weakness, tingling, and numbness. 

Space For The Sciatic Nerve to Heal

Once the stress is taken off of the sciatic nerve in decompressive laminectomy, the sciatic nerve has the space that it needs to heal.

With more room in the spinal canal, the tissues surrounding the nerve can receive ample blood flow, along with the oxygen and nutrients that the blood supplies. This allows for effective regeneration of the damaged nerve.  

What Other Conditions Can Decompressive Laminectomy Treat?

Aside from sciatica, decompressive laminectomy can be used to treat various spinal conditions, including:

  • Lumbar spinal stenosis
  • Herniated, bulging, or ruptured spinal disc
  • Degenerative disc disease
  • Spondylolisthesis

As a form of spinal decompression surgery, decompressive laminectomy may be implemented for many conditions that cause spinal nerve impingement. 

What’s the Success Rate of Decompressive Laminectomy?

Research suggests that decompressive laminectomy has a success rate of around 90%. This high success rate has contributed to the procedure’s standing as one of the most widely implemented forms of spinal decompression.  

Many factors can influence the likelihood of decompressive laminectomy success, including:

  • Underlying medical conditions, like high blood pressure and diabetes
  • Being overweight or obese
  • Smoking or consuming alcohol before and after the procedure
  • Poor nutrition
  • Lack of physical activity
  • High-impact activities or excessive spinal twisting
  • Psychological conditions, including anxiety and depression

Your surgeon will likely discuss these factors with you before the procedure. Many of them are modifiable, meaning that you can change them with healthy lifestyle adjustments in preparation for the procedure. 

The Steps of Decompressive Laminectomy

Laminectomy is typically done under general anesthesia, meaning that the patient is out cold throughout the procedure. As a result, the patient won’t feel any pain or discomfort during the surgery. 

First, your surgeon will create an incision over a specific area of the spine. Then, the surgeon can remove the lamina to free up additional space in the spine.

If needed, the surgeon may perform a discectomy, a foraminotomy, or remove a bone spur. In a discectomy, the surgeon removes a slipped disc. In foraminotomy, the surgeon broadens the passage that holds the spinal nerve root.

Spinal fusion is a common step in decompressive laminectomy to give the spine stability. During spinal fusion, two vertebrae are fused and eventually become one.

Although spinal fusion can prevent spinal insecurity, it significantly lengthens the recovery process and can reduce spinal flexibility. Spinal implants like the TOPS System are an alternative to spinal fusion that allows for less downtime and a greater range of motion in the spine.  

Risks of Decompressive Laminectomy

As a surgical procedure involving the spine, decompressive laminectomy poses certain risks, including:

  • Bleeding
  • Deep vein thrombosis (DVT)
  • Infection
  • Nerve damage
  • Complications from general anesthesia, like headache, nausea, and drowsiness
    • Severe anesthesia complications are rare, but possible. Examples include anaphylaxis, malignant hyperthermia, and accidental awareness

Certain risks come with all forms of spinal surgery, including:

  • Failed back surgery syndrome (FBSS), the term used for spinal pain that occurs or returns after surgical intervention for spinal pain
  • Dural tear, or damage to the dura that covers the spinal cord and nerves
  • Cerebrospinal fluid leakage
  • Hardware failure, which involves damage to the screws, rods, and other hardware used in spinal decompression surgery

Your doctor will evaluate your medical history, family history, and overall health to determine your risk of surgical complications. You may have an elevated risk of these complications if you:

  • Are over the age of 65
  • Are overweight or obese
  • Smoke or have a history of smoking
  • Have underlying medical conditions, including high blood pressure, heart disease, kidney disease, diabetes, and lung conditions

Risks of Decompressive Laminectomy with Spinal Fusion

When decompressive laminectomy is performed with spinal fusion to restabilize the spine, it presents additional risks, including:

  • Failed spinal fusion, or pseudoarthrosis, occurs when the bone graft fails to fuse the targeted vertebrae. This often causes persistent pain and requires reoperation. 
  • Adjacent segment disease can develop in the vertebrae surrounding the fused segment. This condition involves excessive impact on the adjacent vertebrae resulting from the lack of motion at the fusion site. Symptoms include chronic back pain, stiffness, and neurological symptoms. 
  • Lost mobility is a possible complication of laminectomy with fusion. The fusion eliminates all motion at the affected spinal level, which reduces your ability to bend, twist, and extend the spine. The extent of your mobility loss will largely depend on how many vertebrae are fused in the procedure. 

Spinal Fusion Alternatives in Decompressive Laminectomy

Patients who need spinal fusion in decompressive laminectomy for spinal stability should consider spinal implants as an alternative. Spinal implants like the Premia Spine TOPS System can reestablish stability in the spine without compromising the patient’s range of motion. 

Greater Range of Motion

In contrast to spinal fusion, the TOPS System stabilizes the spine while preserving the patient’s freedom of motion. The device provides a controlled range of motion in the lumbar spine so that the patient can safely enjoy their regular activities. 

Faster Recovery Period

The TOPS System allows patients to return to their full range of movement immediately after decompressive laminectomy. With spinal fusion, patients typically need to remain in the hospital for a few days after the surgery and may need several weeks or even months to recover. 

By opting for the TOPS spinal implant instead of spinal fusion in decompressive laminectomy, patients can retain movement in the spine and reduce their recovery time for the procedure. To learn more about this innovative spinal device, contact Premia Spine today.