Lumbar Laminectomy Surgery to Cure Spinal Stenosis
In translation from Greek, stenosis means narrowing. Chronic compression of nerve structures resulting from narrowing the spinal canal is a dangerous, slowly progressive disease. And if earlier the treatment of complex forms included discectomy or decompression, today there is a minimally invasive variant of implantation.
Stenosis can develop for a long time at the cervical, thoracic and lumbar levels. The spinal cord is located at the first two levels of the spinal column; respectively, the compression will affect its integrity, which is fraught with myelopathy. At the lumbar level, the spinal cord ends at the level of 1-2 vertebrae, but the nerves are compressed in most cases. Often hypoxia (oxygen starvation) of the roots is accompanied by pain and subsequent numbness of the lower extremities, muscle weakness.
To understand the treatment of stenosis, you first need to look at its causes and analyze the types of therapy.
How an innovative alternative compares favorably methods with traditional ones, what is rehabilitation, and are there chances of starting a new life without pain, read further in this article.
The human spine is a complex structure made up of many elements. The spinal canal is its central part – the spinal cord passes through it, respectively, any pressure from the side of the bone will result in negative consequences on the functioning of such a vital organ.
Spinal stenosis mostly afflicts older people over 60 years old and is an acquired disease. It most often manifests itself at the lumbar level. It can be caused by the development of a herniated disc, tumor, trauma, arthrosis of the facet joints, the growth of osteophytes, disc protrusion, and the consequence of spondylolisthesis.
Nevertheless, osteoarthritis is the leading cause of changes in the structure of the spinal canal. It consists of wearing out the cartilage tissue and bone growth around the deformed area. That’s how bone spurs (osteophytes) appear, which exert intense pressure on the canal, narrowing it.
By the way, there are cases of congenital (primary) stenosis when the vertebral foramen is underdeveloped. Symptoms begin to appear at a younger age, and compression of the nerve roots can disrupt nerve function and start oxygen starvation of the spinal cord, which leads to pain.
Depending on the area of the spine where the compression is located, the following symptoms may appear:
- Stiffness of movement;
- Numbness and pain in the limbs and back;
- Lumbar muscle tension;
- Poor sensitivity;
- Goosebumps and burning;
- Urinary incontinence;
- Uncontrolled defecation act;
- Decreased libido.
If there is a narrowing in the neck, then the symptoms will spread to the arms, shoulders, shoulder blades, and the back of the head. Conversely, stenosis of the thoracic region is localized in the abdominal cavity and heart.
Please note! The disease manifestations may be reduced by leaning forward, sitting, or stopping and not moving.
Diagnosis of any disease is impossible without complaints and medical history. Guiding questions about the nature of pain, its localization, the effect on the ability to move, and performing specific exercises will help the doctor recognize the symptoms. Further, using radiography of the spine and magnetic resonance imaging (MRI), bone and cartilage tissue degradation and the degree of narrowing of the canal are established. Sometimes, in complex cases, multispiral computed tomography (MSCT) is prescribed.
Treatment of spinal stenosis can be conservative and operative. Conventional therapy includes treatment with analgesics, vascular and anti-inflammatory drugs. However, such a system is often not effective enough.
The surgical intervention also has several features and can be performed using several approaches:
- decompression laminectomy;
- installation of interspinous fixation systems;
- installation of stabilizing systems.
The decompressive operation involves the resection of structures that compress nerves using a lumbar laminectomy surgery implant. Historically, this type of surgery is considered a traditional approach to treatment. However, it’s already outdated. Many shortcomings are the reason for the lack of effectiveness of the procedure: it involves removing structures that form the supporting column of the spine (Holdsworth). That leads to its instability, and soon the risk of developing unsuccessfully operated spine syndrome. In addition, there are disorders in the biomechanics of the spinal motion segments adjacent to the stabilized ones, which are manifested by their hypermobility. All this leads to the development of spondylolisthesis, spinal stenosis, fractures, scoliosis.
A feature of interspinous dynamic fixation systems is the ability to perform both flexion and extension. In this case, the load on the intervertebral joints is reduced due to the roots decompression by holes enlarging. A contraindication to this procedure is instability in the spinal motion segment.
Stabilizing systems are constantly improving, but the fact remains: the axial load is evenly distributed between the vertebrae. In this case, the recovery time is minimal, and the effect is the best. It’s essential to understand that, unlike a lumbar laminectomy surgery, an implant has the best chance of restoring the entire range of movements and eliminates a huge number of postoperative complications.
What results to expect from surgical treatment?
Usually, after surgery, severe pain can last for a month. In the case of fusion, the pain can last 3-6 months! But not in the case of the TOPS™ implant. The fact is that after two weeks, you’ll be able to stop the course of painkillers (read more about this here), as the operation is considered minimally invasive.
To quickly and effectively undergo rehabilitation, both for athletes and older people, it’s essential not to stress the segments. Excess weight lifting (up to 8 pounds), twisting, bending can lead to this. It is crucial to maintain a stable activity level: take short walks, do household chores, and start driving to recover. Within 4-6 weeks, most patients can return to school, work, or play sports.
Stenosis is a pathological narrowing of the spinal canal and compression of the nerve roots. That leads to constant pain in the back and numbness and deterioration of the sensitivity of the limbs. Laminectomy is a traditional method of treating stenosis, but today the technique is considered outdated and unsafe for the patient’s life. Several complications after surgery can provoke the occurrence of spondylolisthesis, fractures, scoliosis, etc. Many physicians choose to use other treatment techniques, although a clear advantage of laminectomy is access to a relatively wide range of movements in case of complete recovery.
TOPS™ implants have become an alternative to standard surgical stabilization systems and are a breakthrough in medicine. It’s all about the minimal invasiveness, a small amount of risk compared with other manipulations, and most importantly, any movements’ availability without any restrictions. The recovery in this case also occurs relatively quickly, making it possible for the TOPS™ system to become a favorite option among patients.