In lumbar spinal stenosis, compression of the spinal nerve roots in the lower back can cause pain. If the symptomatic stenosis area localizes to a few spots, modern minimally invasive spinal surgery techniques can be used to perform a focused decompression of the specific areas of stenosis.
Learn more: Lumbar Spinal Stenosis: A Definitive GuideLumbar Laminectomy Surgery Video
Similar to the process for lumbar discectomy, fluoroscopic guidance can be used to localize the area of stenosis. By use of small retractors, tubular retractors, and magnification, the surgeon can precisely remove the bone spurs and hypertrophic, or enlarged, ligaments causing the stenosis with minimal disruption of other spine structures.
While the longer-term effects of minimizing the soft tissue dissection may not be completely understood, clinicians are hoping the minimal soft tissue disruption will also reduce the chances of developing laminectomy-related spinal instability patterns.
Outpatient lumbar decompression techniques reduce the surgical exposure, while achieving the removal of the spinal stenosis-causing structures. For the carefully selected patient, there is a high level of satisfaction, with minimal added risk with the outpatient process.6
Lumbar Interspinous/Intralaminar Spacers: A Limited Option
Some surgeons will offer lumbar interspinous/intralaminar spacer devices to indirectly decompress and relieve foraminal and central canal stenosis or to augment a decompression procedure for stability. Using similar targeting and dissection techniques as lumbar discectomy, the goal is to minimize trauma to the tissues.
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To have the procedure as an outpatient, the surgery should be limited to one or two levels of the spine. Appropriate use of local anesthetic agents minimize the initial incisional pain, and a carefully selected patient can go home after these types of lumbar surgery.
- Lee MJ, Kalfas I, Holmer H, Skelly A. Outpatient surgery in the cervical spine: is it safe? Evid Based Spine Care J. 2014;5(2):101-11