When Do I Need Surgery For Back Pain? Laminectomy vs Laminotomy

Does Your Back Pain Require Surgery?

Everyone’s experienced back pain at some point. Some people simply have muscle sprains and strains. Others have complex, long-term spinal issues. Cases of chronic pain continue to increase in numbers and severity every year. The increase in these cases has also seen a rise in surgeries. For spinal issues, a laminectomy or laminotomy are two of the most common procedures. Back patients should know when a doctor will recommend back surgery and the difference between the two.

Reasons for long-term back pain

Most chronic back pain can be linked to a severe injury or condition involving the spine. The spine is made of several stacked bones called vertebrae. Between each pair of vertebrae are fibrous discs, which help with movement and shock absorption. Sometimes, these discs slip out of place, pressing on surrounding nerves. In other cases, the bones themselves can develop spurs or arthritis. These ailments can reduce the space for the nerves branching out of the spine. Any of these can cause nerve pain and weakness.

Are these treatment options working?

So when would be a good time for surgery? With any spinal condition, a doctor will try non-surgical treatment options first. The spine is a delicate part of the body, and a surgeon will not operate unnecessarily. Non-surgical treatment includes NSAIDs, steroid injections, and physical therapy. Some patients even try chiropractic care and other alternative forms of medicine. If these fail, surgery is a viable option.

A clear sign that something’s wrong

In some cases, non-surgical treatment is only delaying the inevitable. The doctor will need to go straight to surgery. For instance, if a bone spur is pressing on the nerves and spine, non-surgical treatment may not help. Another reason could be a slipped disc or compression fracture that would not respond to treatment.

Look out for these serious symptoms

If a disc or bone spur presses on the surrounding nerves, there could be other serious side effects. Some people could feel weakness in the arms and legs. Simple tasks like walking or lifting become difficult. Other severe symptoms include a loss of bladder control or sciatica. When these symptoms occur, a surgeon may try a laminectomy or laminotomy.

Laminectomy vs laminotomy

The goal of spinal surgery is to relieve the pressure on nerves that cause pain. A spinal surgeon can achieve this with either a laminectomy or a laminotomy. The lamina is a bony plate that covers and protects the spine. The goal of each procedure is to give the nerves some more space through this bone. The difference between the surgeries depends on the amount of bone removed. A laminectomy removes the entire lamina to decompress the spine. A laminotomy, on the other hand, removes part of the bone. Surgeons can now perform both procedures using minimally invasive means.

What to expect during surgery

Based on the extent of the spinal condition, the surgeon will decide on which surgery is best. Both will require the patient to lie facedown so the surgeon can access the spine. The surgeon will make small incisions for a small camera and tools to access the lamina. From there, some or all of the bone is removed. A spinal fusion or discectomy may accompany a laminectomy or laminotomy.

Get your back pain under control

Surgery is not the first step in dealing with back pain. Most cases can be managed with non-surgical means. But if the treatment is unresponsive or where the damage is progressively worse, surgery will be best. Based on the nerve pressure, the surgeon will choose the procedure that will provide the best results.


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