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Laminectomy Alternatives

A laminectomy procedure is a surgical treatment for a herniated disc. A herniated disc can cause pain in the back, arms, legs, hands and feet. Because the procedure requires an incision of up to five inches in the back and requires removing parts of the spinal canal, it is important for patients to evaluate alternatives to this procedure.

  1. Non-Surgical Alternatives

    • If you experience a herniated disc, it is typically best to practice conservative methods to see if the disc will heal on its own. Conservative treatments may include applying a heating pad or ice pack, wearing a back brace, performing physical therapy exercises, getting epidural injections or receiving electrical stimulation therapy treatments. If the pain does not improve in six to 12 weeks, as a general rule, it will not improve at all using these methods.

    Spinal Fusion

    • A spinal fusion corrects a herniated disc by fusing two vertebrae together in order to strengthen the spine. Small pieces of bone may also be placed in the area to be fused together in order for the spine to retain its shape and structure. A drawback of this surgery type is that it can limit motion in the spine, yet it is one of the most commonly performed spinal procedures, according to the American Academy of Orthopedic Surgery.

    Microdiscectomy

    • If a patient experiences leg pain associated with a herniated disc, a microdiscectomy procedure may be a good alternative to a laminectomy. A microdiscectomy involves removing bone or diseased disc material from over a nerve root. This helps to relieve herniated disc pain due to neural impingement. The incision is smaller than a laminectomy incision (1- to 1 1/2-inch incision for a miscrodiscectomy). Compared to a spinal fusion, a microdiscectomy does not reduce range of motion as significantly.

    Minimally Invasive Laminotomy

    • Similar to discectomy, a minimally invasive laminotomy utilizes small incisions to access the spine. The procedure removes the ligament flavum, a ligament in the spinal canal that can enlarge and press on the nerves within. Just as a laminectomy removes diseased material to make more space for the injured nerve, a laminotomy creates more space in the spinal canal to release the nerve. A laminotomy approach utilizes only local anesthesia and requires only a short recovery period.

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