nerves can become compressed either because of enlarged ligaments, bony spurs or a disc herniation/disc bulge.  This condition is referred to as stenosis.  In a laminectomy portions of the back part of the vertebra, called the lamina, are removed.  This enlarges the diameter of the spinal canal and allows more room for compressed nerves.  This relieves pain and improves nerve function.

How is an endoscopic laminectomy performed?

Most laminectomies today are performed microscopically.  Using a 22 millimeter tube the surgeon inserts drills and specialized tools to enlarge the opening of the spinal canal by removing portions of the lamina.  Endoscopic surgery is a new way of performing laminectomy.  The size of the operating tube is reduced to 8-10 millimeters.  By allowing a smaller tube there is less damage to muscles and normal ligaments and bone.  This allows the surgeon to focus on decompressing the nerve roots while minimizing collateral damage.

What are the advantages of performing an endoscopic laminectomy?

Endoscopic laminectomy can be performed as an outpatient procedure.  The smaller surgical opening reduces collateral damage to important ligaments, joints and bone.  This allows a more rapid recovery.  Typically the patient will return home the same day.  After an evening of rest the patient can expect to walk freely on the day after surgery. 

How long will the procedure take?

The patient will return home the day of the procedure.  Medications will be prescribed for pain and spasm.  For the first 2–3 days we advise plenty of rest with light stretching.  Activity should be tolerably increased over 7 days and should consist of short walks at first and a gradual return to normal daily activities.  Avoid strenuous activity, heavy lifting (over 10 to 15 pounds) and twisting for the first several months. If your job is sedentary then work can be resumed in 7 days.  At 4 weeks physical therapy or chiropractic care can be resumed. Since the procedure is minimally invasive rehabilitation will generally be easier and faster than with traditional surgery. Recovery time will vary based on individual factors.

The 4 Pillars of Treating Chronic Spinal Pain

George Rappard MD discusses the 4 key pillars of spine care. The 4 pillars are physical therapy and chiropractic care tailored to your condition, appropriate selection of medical therapy, pain injections targeting your specific pain source and, as a last result, minimally invasive motion and stability preserving spinal surgery performed as an outpatient procedure. Through effective use of the first 3 pillars only about 5% of our patients need to go on to have back surgery or neck surgery.

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