Decompression surgery, or laminectomy, is carried out to relieve pressure on the spinal cord or nerve roots. The pressure may be the result of fracture fragments, disc fragments, bone spurs, tumors, and/or infections.
Decompression surgery often helps to relieve leg pain, numbness, tingling, and/or weakness. Pressure on the nerves is alleviated by removing disc material or bone from the spine. This type of surgery typically allows patients to move with greater ease.
Certain back and leg symptoms are caused by pressure on a nerve. This pressure is often found to originate from a damaged disc or by bone growth. Constant wear and tear can make a disc weak and worn out, causing the disc to bulge. If the outside of the disc (the annulus) tears, the soft insides of the disc can herniate out and pinch your nerves. As your spine ages, bone spurs can also form and grow into the foramen (the area where the nerve comes out) of your vertebrae. The bone spurs then press on your nerves in the spinal canal or through the foramen. In other instances, the joints in your spine (facets) can enlarge with arthritis and press on your nerves. It is also possible that the ligament holding your vertebra together can thicken, causing further spinal stenosis (narrowing of the spinal canal) and additional pressure on the nerves.
At our practice, our experienced spinal surgeon in Manhattan—Dr. Jun Kim—offers various decompression/laminectomy procedures to relieve this pressure depending on its location.
Posterior Cervical Decompression (Posterior Cervical Laminectomy/Foraminotomy)
Dr. Kim may discuss a posterior cervical foraminotomy and/or a laminectomy if you have a pinched nerve or a compressed spinal cord. This can manifest as cervical radiculopathy (pain radiating down the arm or around the shoulder or shoulder blades) and/or cervical myelopathy (weakness, hand clumsiness, imbalance when walking or standing, clumsiness in gait, numbness, pain).
To perform a posterior cervical foraminotomy, Dr. Kim will make an incision on your back to allow him access to the cervical spine. If he’s doing a cervical foraminotomy, this may be done in a minimally invasive fashion through a tube and small incision about the size of a nickel. He uses an operating microscope to decompress the nerve root that is the origin of your symptoms.
To perform a posterior cervical laminectomy, Dr. Kim will use a midline incision to allow him access to the cervical spine. He will remove the lamina or the posterior arch of spine in order to decompress or create room for your spinal cord and nerve roots. Imagine if your spinal cord was being compressed between your steering wheel and your car seat. A laminectomy effectively creates room for your spinal cord by shifting back the car seat.
Lumbar Laminectomy (Open or MIS)
To perform lumbar laminectomy, Dr. Kim will make an incision on your back that allows him to access the affected area. The incision size will vary depending on how many levels of your spine Dr. Kim needs to address. To help enlarge the view of your spine and ensure accuracy during the surgery, Dr. Kim uses a specialized microscope. During the procedure, Dr. Kim will remove a small piece of bone (the lamina) to allow access to the herniated disc, ligament, or bone spurs that may be pressing on your nerves. This is called a laminotomy. If there is no herniated disc, the laminotomy alone will help take pressure off of the nerve. He may also remove bone in the foramen area, if necessary (foraminotomy). This will create room for your nerves and take the pressure off of them, thus eliminating pain, weakness, and numbness.
When the surgery is completed, Dr. Kim will close your incision with dissolvable sutures under the skin and DERMABOND® PRINEO® on the outside of your incision.