Lumbar laminectomy deals with removing portions of laminae from the spine. These laminae are often called “shingles” for your spine, as they are bony segments that help muscles attach to the spine in addition to protecting nerve roots.
During this surgery, some of these laminae are removed in order to treat compression in the lower part of the spine. This compression can be caused by degenerative spine disorders or prolapsed discs.
What is a lumbar laminectomy and rhizolysis?
A lumbar laminectomy and rhizolysis is an operation on the spine in the lower back. Its purpose is to relieve pressure on the nerve roots that leave the spine and run down to form the nerves in your legs. The back of the spine has a bony ‘shingle’ on either side of the midline. These angled segments of bone are known as the laminae, and their purpose is to permit muscles to attach to the spine and also to protect the nerve roots. Removal of portions of these laminae is known as a ‘laminectomy’, ‘hemilaminectomy’, or ‘partial hemilaminectomy’.
By simply removing portions of the laminae, the underlying nerve roots may remain somewhat compressed. To adequately decompress the nerve root, it is often necessary to remove part of the facet joint (‘mesial facetectomy’), as well as any thickened ligament. Decompression of a nerve root is known in surgical terms as a ‘rhizolysis’.
The bony structures of your spine are carefully defined, and using microsurgical techniques, a fine high-speed drill is used to shave some bone away over the top of the nerves. The ligament is then detached and removed and the underlying nerve root is identified. The nerve root is decompressed (this is known as a ‘rhizolysis’) and the disc is visualised. If there is a significant disc prolapse, a microdiscectomy is performed; otherwise the disc is left alone.
If the disc is to be removed (microdiscectomy), this is done by first cutting the outer annulus fibrosis (fibrous ring around the disc) and removing the nucleus pulposus (the soft inner core of the disc). Disc removal is performed using a combination of special instruments.
The wound is closed with dissolving sutures. Followed by glue then steri strips.