Mar 2, 2018

Sometimes a narrowing of the spinal canal can lead to less room for the nerves, which causes them to be pinched. We call this spinal stenosis. Not all pinched nerves are caused by spinal stenosis, but when it occurs in the low back it can cause serious symptoms that could require surgery.

Lumbar laminectomy and foraminotomy is a common operation designed to relieve pressure on the nerves in the low back. Spinal stenosis can cause pain, numbness, and tingling or weakness in the legs. If one or two nerves are pinched, the symptoms are commonly known as sciatica. But if numerous nerves are involved at the same time, it can cause symptoms such as a limited ability to walk distances and heaviness in the legs.

Sometimes spinal stenosis is developmental. It can start early in life but you might not see any symptoms until adulthood. It can also be degenerative, caused by aging of the joints and the disc resulting in a narrowed canal. There may also be a herniated or ruptured disc causing even more symptoms.

Generally, as spinal stenosis progresses over time, non-surgical treatments tend to be less successful and normal daily activities can become severely limited. That’s when you and your doctor might decide that it’s time for surgery.

During the operation, an incision is made on the low back under general anesthesia. The bone on the back of the spine (lamina) is removed, which relieves the narrowing in the middle of the canal. Next, we open the channel (foramina) where the nerves exit the spine. Then the muscles on the back of the spine are re-attached to cover the middle of the canal and the bony defect created by the laminectomy.

Patients typically spend just a day or two in the hospital. I recommend wearing a brace until physical therapy starts in 4-6 weeks. You can resume normal activities around six weeks after surgery.

This surgery is successful 70-90% of the time, but occasionally the spine has to be stabilized (fused) to maintain the space for the nerves.