18 Mar Spinal stenosis: Minimally invasive laminotomy is superior compared to traditional laminectomy and spinal fusion
Spinal stenosis is a diagnosis made when there is a narrowing of the spaces in the spine, which may cause compression of the nerves that travel to your arms and legs. It occurs most commonly in the lower back and the neck. It occurs most commonly due to degeneration as one ages, or it can also occur as a result of trauma.
Most patients with spinal stenosis are 50 or older as the spinal canal (spaces in the spine) starts to narrow around this age. Although some patients may not have any symptoms, some can present with pain, tingling (pins and needles sensation), and numbness that may radiate down the affected limb.
Conservative management is usually recommended for patients with symptoms. If conservative treatment is not effective, spinal surgery may be recommended as the next step of treatment. The traditional open surgery for spinal stenosis is called a laminectomy and fusion procedure. This surgery aims to relieve the pressure of the compressed nerve and widen the space in the spinal canal.
Traditional spine surgery has an increased risk of infection, blood loss, increased duration of hospital stay, and increased recovery time for the patient. It is also a highly invasive procedure compared to minimally invasive keyhole laminotomy.
The recovery time for traditional spinal surgery can be lengthy and the hospitalization duration is increased as the surgery involved the complete removal of parts of the vertebrae (spine) and other components. It also requires the manipulation of the soft tissues around the vertebrae which may lead to more pain after surgery compared to minimally invasive keyhole laminotomy.
In minimally invasive keyhole laminotomy, a small incision is made on the spine and a small opening is created to enable the use of a laser, camera, suction and other surgical tools that are required in the surgery. In this procedure, there is minimal damage to the soft tissue surrounding the vertebrae as the structures are gently pushed aside, instead of being cut. The next step involves the removal of a small portion of the spine, only the part that is absolutely necessary as it is needed to decompress (remove pressure) from the nerve that is affected.
After the surgery is performed, most patients may be able to start moving, getting out of bed on the same day. Most patients who go through minimally invasive keyhole laminotomy do not require an overnight hospital stay. The recovery time for patients are also much faster and there is earlier return to work and routine activities when compared to the traditional spinal surgery. There may be some pain after surgery and patients will be given pain medication. Physical therapy may also be recommended to help patients have a better recovery.
Inspired Spine’s minimally invasive keyhole procedures offer quick recovery and minimal blood loss. The spine surgeons are incredibly adept at the procedures, with most insurance being accepted!
- Fessler RG, Khoo KM, Khoo LT. Lumbar spinal stenosis treated using minimally invasive keyhole microsurgical techniques. Spine Universe. http://www.spineuniverse.com:8080/conditions/spinal-stenosis/lumbar-spinal-stenosis-treated-using-minimally. Accessed 3/5/2017.
- Minimally invasive laminotomy vs traditional laminectomy and spinal fusion. Laser Spine Institute. https://www.laserspineinstitute.com/articles/fusion_articles/laminectomy_fusion/38/. Accessed 3/5/2017.