What is Lumbar Discectomy and Laminectomy?

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 Neurosurgeon, discusses lumbar discectomy and laminectomy.

 Neurosurgeon, discusses lumbar discectomy and laminectomy.

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Video transcript

Featuring Dr. Ramesh Sahjpaul, MD, MSc, FRCSC, Neurosurgeon

Video Title: What is Lumbar Discectomy and Laminectomy? Duration: 2 minutes, 49 seconds

Some of the most common operations that we do for the spine are lumbar microdiscectomy and lumbar laminectomy.  

So lumbar fusion surgery is sometimes necessary for back pain, but in that situation one has to carefully correlate the clinical findings with the imaging findings. For most of the common back operations that we do, lumbar discectomy or lumbar laminectomy, a fairly small incision is made in the back approximately inch, inch-and-a-half in length.

Using microsurgical techniques we expose the nerves that are compressed and remove the offending herniated disc or bone spurs that are causing nerve compression, and this is an example of a disc herniation that may cause pressure on the nerves.  

And again that’s a fairly quick operation with a very good success rate often requiring no more than 45 minutes to an hour of surgical time, blood loss is minimal, perhaps no more than two teaspoons of blood is lost, and patients are usually up and about within a few hours of surgery and quite often they can leave the same day.  Sometimes it may require an overnight stay.

And these surgeries are actually very effective in relieving symptoms of sciatica, so pain, numbness, weakness in the legs, and the response is almost always immediate.  Sometimes lumbar fusion surgery is necessary, which is a bigger operation, and the indications are very different.  

Lumbar fusion is necessary if somebody has a deformity or instability in the spine. It’s a bigger operation, but even so with current techniques available we can usually do that surgery through fairly small incisions. Nevertheless, it does require a few more days in the hospital.

But the important thing to recognize is that lumbar fusion is very rarely necessary for sciatica or spinal stenosis. It can be helpful for situations of back pain, but the clinical symptoms need to be correlated with the imaging findings.  

So one of the most important things to recognize and appreciate is that while spine surgery can be very helpful, it is reserved for a specific condition such as disc herniations, spinal stenosis, spinal deformity, and it’s rarely needed for situations such as back pain alone, which is usually treated conservatively.  

When spine surgery is necessary, there are a number of different options in terms of how to perform the surgery, but the important thing to recognize is that if the indications are correct, and the correct surgery is chosen, the results with spinal surgical procedures are very satisfying.

Presenter: Dr. Ramesh Sahjpaul, Neurosurgeon, Vancouver, BC

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97-100 People got two or more of these video questions wrong... ( 65 participated.)

Quiz: Do You Understand Back Pain?

Questions
 
True
False
1

Lumbar back pain is the most common type of back pain.

Explanation:

Back pain symptoms can be mild or severe, and cervical (neck pain), thoracic (middle back pain), lumbar (lower back pain) or tailbone/sacral (coccydynia). Lumbar back pain is the most common type.

2

Back pain isn't caused by medical problems involving the gallbladder or kidneys.

Explanation:

Back pain can come from muscles, bones, joints or nerves. It can also be caused by medical problems involving the gallbladder, aorta, kidneys or pancreas.

3

Scoliosis is a back condition but it doesn't cause back pain.

Explanation:

Back pain causes include injury or activity, arthritis, back strain, sciatica, poor posture, aging and scoliosis.

4

Back pain symptoms include pain that radiates down your leg.

Explanation:

Back pain symptoms include shooting or stabbing pain, pain that radiates down the leg, muscle aches, pain that worsens when you walk, lift something, bend or stand, and pain that improves when you recline.

5

Most patients with back pain will require surgery.

Explanation:

In most cases, back pain will resolve on its own with treatment at home and over-the-counter medications. Some patients benefit from spinal traction, a physiotherapy technique that applies a longitudinal stretch to the reachable joints and soft tissues that is commonly used on the cervical, lumbar spine and thoracic spine. Surgery is not usually recommended.

This content is for informational purposes only, and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding a medical condition.

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