Most patients with spinal stenosis or disc prolapsed respond well to non-surgical treatments. However, there are situations when you may want to go ahead with spine surgery.
One main goal of spinal stenosis surgery is to free up area for your spinal cord and/or the nerve roots. That’s called decompression. By giving your spinal cord and nerve roots more space to pass through, we hope to decrease your pain from nerve inflammation.
Another goal of spinal stenosis surgery is to increase your motor strength in your arms or legs. If you’ve lost sensation in your arms or legs, we also hope to restore that. To remove the tissue that’s pressing on a nerve, we may perform one of the following types of surgery.
Foraminotomy: If part of the disc or a bone spur (osteophyte) is pressing on a nerve as it leaves the vertebra (through an exit called the foramen), a foraminotomy may be done. Otomy means “to make an opening.” So a foraminotomy is making the opening of the foramen larger, so the nerve can exit without being compressed.
Laminotomy: Similar to the foraminotomy, a laminotomy makes a larger opening, this time in your bony plate protecting your spinal canal and spinal cord (the lamina). The lamina may be pressing on your nerve, so the surgeon may make more room for the nerves using a laminotomy.
Laminectomy: Sometimes, a laminotomy is not sufficient. The surgeon may need to remove all or part of the lamina, and this procedure is called a laminectomy. This can often be done at many levels without any harmful effects.
Indirect decompression is a variation of decompression surgery where pressure is relieved by spreading the bones apart instead of removing bone. This can be done with instrumentation (hardware), such as inter spinous process devices or inter body cages. Even artificial discs can accomplish some indirect decompression by restoring the height between adjacent vertebrae.