TREATMENTS
POSTERIOR SPINAL DECOMPRESSION
Posterior spinal decompression occurs anywhere along the spine, running from the cervical region to the lower back.
Posterior Spinal Decompression
Different types of posterior spinal decompression surgeries include:
Laminotomy
A laminotomy is a surgery done to decompress the spinal canal and reduce pressure on the spinal cord in the cervical or lumbar region. This procedure is a type of spine surgery performed unilaterally on the left or right side. A laminotomy treats spinal stenosis that occurs when the spinal canal begins to tighten and causes a lack of sensation in the legs, pain and issues with balance.
A laminotomy is usually performed to treat:
- Radiculopathy occurs from pinching the nerve in the spine, causing a tingling sensation, pain and weakness.
- Neurogenic claudication arises from compressed nerves in the lumbar spine.
Dr Makan performs a laminotomy while the patient is under general anaesthesia. First, he uses x-ray imaging to locate the problem in the vertebrae. Next, he creates a tiny incision on the back and uses a retractor to move apart the muscles to reach the spine. Once he reaches the affected region, he uses a burr (drill) to create an opening in the lamina and lifts a heavy ligament (Ligamentum Flavum) from the spinal cord. This ligament thickens as we age, placing significant pressure on the spinal cord and nerves. Finally, he decompresses the area on either side and ensures any obstructive material is removed.
Laminectomy
Laminectomy is a procedure to remove a section or the entire lamina to reduce pressure on the spinal cord and nerves. Dr Makan considers a laminectomy when medication and physiotherapy do not relieve neck or lower back pain.
A laminectomy is conducted to reduce pressure on the spinal nerve roots as a result of:
- Spinal stenosis
- Herniated disc
- Spinal tumours
Dr Makan carries out a laminectomy under general anaesthesia. He creates an incision over the affected vertebrae and spreads the muscles away on either side. Afterwards, he dissects the bony arch (lamina) to reduce pressure in the area. In addition, Dr Makan removes bone growths or damaged parts of a herniated disc. He may also carry out spinal fusion in case the spine is unstable.
Facetectomy
A facetectomy is a surgical procedure performed to remove facet joints running on either side of the vertebrae. This surgery is often performed in conjunction with spinal fusion.
Facetectomy occurs due to:
- Leg pain
- A tingling feeling in the legs
- Bowel incontinence
A facetectomy takes place under general anaesthetic while Dr Makan makes use of fluoroscopy to view the surgical site. First, he makes an incision in the centre of the back and moves a muscle aside to reach the facet joints. After this, he dissects cartilage and ligament surrounding the joint. Pieces of bone and the inside of a herniated disc are removed as well. Finally, Dr Makan seals the incision site using sutures.
FAQ
Dr Makan will prescribe painkillers and slowly wean you off the anaesthesia. Then, you will be transferred to the recovery room, where you will be closely monitored. Within one to two days, you will be discharged from the hospital.
You can engage in light activities within days or weeks after surgery. However, a full recovery may take two to four months. Usually, it takes longer to recover when spinal fusion occurs together with a laminectomy.
Although a laminotomy is considered major surgery, with a few risks, the benefits are vast, especially when factoring in less invasive surgical techniques.