Minimally Invasive Microsurgical Lumbar Laminoplasty Requires Specialized Training and Equipment

Surgery Dr. Sahni, Laminoplasty

If you’ve been diagnosed with lumbar stenosis, chances are you developed the condition long before you experienced any symptoms. Like many adults affected by this degenerative disorder, you probably didn’t learn that the spinal canal in your lower back was gradually narrowing until you started experiencing chronic back pain.

Rest, anti-inflammatory pain relievers, physical therapy, and epidural steroid injections can go a long way in easing stenosis-related back discomfort, but conservative measures can’t always provide adequate relief as the condition progresses. When chronic lower back pain leads to numbness, tingling, or weakness in one or both of your legs, surgery may be the best solution.

While learning that you’re a good candidate for back surgery can be a bit worrisome, ongoing advances in minimally invasive spine surgery (MISS) have made it possible to attain the same exceptional results as traditional open surgery, but with much smaller incisions, minimal tissue trauma, less pain, and faster post-procedural recovery and rehabilitation.     

Here at Capital Brain and Spine surgery center in Austin, Texas, we specialize in minimally invasive spinal surgery, and we know just how beneficial it can be when it comes to limiting the kind of collateral damage that can occur in conventional open surgery.  

Let’s explore what makes minimally invasive microsurgical lumbar laminoplasty so different from — and often better than — conventional laminoplasty surgery.

Laminoplasty basics

Laminoplasty is a procedure used to relieve abnormal pressure in the spinal cord by surgically creating more space within a narrowed (or impinged) section of backbone for the spinal cord and its nerve roots.

As a motion-preserving surgery designed to alleviate chronic nerve-related pain and restore a more optimal range of motion, laminoplasty is often used to correct stenosis in the lower back (lumbar spine) or neck (cervical spine). It can also be used to access and treat a problematic bone spur, an abnormal growth (tumor), or a fluid-filled cyst (syringomyelia).  

Laminoplasty is performed by cutting open one side of the lamina, or the protective bony arch that covers your spinal cord; a partial cut on the other side helps create a door-like hinge.

While partially opening the lamina may be all it takes to decompress your spine and relieve painful nerve pressure, your surgeon also removes any bone spurs or abnormal growths that may be compressing your spine or impinging on nearby nerves.

Small wedges of bone (or in some cases, surgical screws) are set in place to keep the “door” in your vertebrae propped open, helping to ensure that the newly freed space around the spinal cord in your lower back remains open.  

Conventional techniques

Conventional laminoplasty requires a relatively long incision along your lower back that allows your surgeon to visualize your spine and the surrounding structures clearly and access them easily.

To help create a completely unobstructed “window” to your spine in traditional open surgery, your doctor must also dissect overlying muscle and other tissues and move them aside.  

Although this time-honored approach can provide excellent outcomes, dissecting or otherwise disrupting spinal muscles and other supporting tissues also comes with a greater risk of post-procedural pain and instability.

The so-called “collateral damage” of open surgery also means it usually takes a significant amount of time to heal, recover, and rehabilitate following a conventional laminoplasty.

Minimally invasive methods

As the name implies, minimally invasive surgery aims to achieve the same favorable outcome as traditional open surgery, but without disrupting, harming, or otherwise inflicting damage on supporting soft tissues.

To lessen the risk of collateral damage as much as possible, minimally invasive surgery relies on innovative techniques as well as specialized equipment. A minimally invasive lumbar laminoplasty uses a very small incision (often shorter than an inch) to access the compressed spinal cord in your lower back with minimal intrusion to the surrounding tissues.

To help Dr. Sahni see your spine clearly through this small opening, he inserts a tubular retractor — a stiff, tube-shaped surgical tool — that gently and temporarily pushes aside muscle and other soft tissue to create a narrow tunnel to your spine.

Then, with the aid of a special operating microscope and real-time, high-definition X-ray images of your spine, Dr. Sahni uses small, specialized instruments to perform the operation through the tunnel. Besides causing very little disruption or trauma to nearby soft tissues, this technique also minimizes muscle damage and helps prevent excessive blood loss.

While traditional open surgery is still the best way to achieve an optimal outcome when it comes to treating high-degree scoliosis or removing a spinal tumor, we can use MISS techniques to address a wide range of persistent spinal problems that don’t respond to conservative measures — safely, effectively, and without causing unnecessary collateral damage.

To learn more about the benefits of minimally invasive techniques in spinal surgery, call our Austin office today, or use the easy online tool to schedule a consultation with Dr. Sahni any time.

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