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What Is the Difference between a Laminectomy and a Microdiscectomy?

Written by The Barricaid Team | May 17, 2024 6:50:00 AM


Back pain is one of the most common ailments affecting people across the globe, often leading to surgical interventions when conservative treatments fail to provide relief. Two such surgical procedures, laminectomy and microdiscectomy, are frequently used to address back pain due to different causes. What are the key differences between these procedures, and when is each one indicated? This article will delve into the details to help you understand these two surgical approaches.

Understanding the Spine and Back Pain

The human spine is a complex structure comprising vertebrae, intervertebral discs, the spinal cord, and nerves. It plays a crucial role in supporting the body and allowing flexibility and movement. However, due to aging, injury, or degenerative conditions, the spine can experience issues leading to chronic pain, nerve compression, or other debilitating symptoms.

When conservative treatments such as physical therapy, medications, or injections fail to relieve back pain, surgical options such as laminectomy and microdiscectomy may be discussed and potentially recommended. Each procedure has specific indications and is designed to address different underlying causes of back pain.

When a Laminectomy Is Indicated

A laminectomy, also known as decompression surgery, involves removing a portion of the lamina—the bony arch on the posterior aspect of the vertebra—to relieve pressure on the spinal cord or nerves. Laminectomy is typically indicated in cases where there is significant compression of the spinal cord or nerves due to conditions such as spinal stenosis, tumors, or severe arthritis. It is particularly effective in creating space within the spinal canal to alleviate pressure on the nerves.

How a Laminectomy Is Performed

During a laminectomy, the patient is placed under general anesthesia. The surgeon makes an incision in the back, identifies the affected vertebrae, and removes a portion of the lamina. This decompression allows the spinal cord or nerves to function more freely. In some cases, additional procedures such as spinal fusion may be performed to stabilize the spine.

When a Microdiscectomy Is Indicated

On the other hand, a microdiscectomy is a minimally invasive procedure specifically designed to address herniated discs causing radicular pain, sciatica, or numbness or weakness in the legs. It involves removing the portion of the intervertebral disc that is pressing on the spinal nerve, thereby relieving pain and restoring function. Unlike a laminectomy, which involves removing bone, a microdiscectomy focuses solely on the disc material that is causing compression.

How a Microdiscectomy Is Performed

As with laminectomy, general anesthesia is also used during a microdiscectomy. The surgeon makes a small incision over the affected area and uses specialized instruments and a microscope to access the herniated disc. A portion of the disc material is removed, relieving pressure on the nerve. The smaller incision and focused approach contribute to a faster recovery compared to more invasive techniques.

Key Differences between Laminectomy and Microdiscectomy

  • Scope of Procedure
    • Laminectomy addresses issues related to the spinal canal, such as spinal stenosis, by removing bone and tissue to create space.
    • Microdiscectomy targets herniated discs specifically, focusing on removing the portion of the disc pressing on the nerve.
  • Surgical Approach
    • Laminectomy typically involves a larger incision and more extensive tissue removal compared to microdiscectomy.
    • Microdiscectomy is minimally invasive, often performed through a smaller incision with the assistance of a microscope or endoscope.
  • Recovery Time
    • Laminectomy may require a longer recovery period due to the more invasive nature of the procedure.
    • Microdiscectomy often allows for quicker recovery times and shorter hospital stays.
  • Risk Factors
    • Laminectomy carries a slightly higher risk of complications, such as spinal instability or infection, due to the more extensive tissue removal.
    • Microdiscectomy is generally associated with fewer risks, although complications such as nerve damage or recurrent disc herniation are possible.

While both laminectomy and microdiscectomy are surgical options for addressing spinal issues, they differ in their scope, approach, and intended outcomes. Understanding these differences is essential for patients and their healthcare providers to make informed decisions regarding treatment. Whether it is creating space within the spinal canal with a laminectomy or targeting a herniated disc with a microdiscectomy, the ultimate goal is to alleviate pain and improve quality of life for individuals suffering from spinal conditions. If you are experiencing chronic back pain and conservative treatments are not working, consult with a spine specialist to determine if one of these surgical approaches might be right for you.

Although microdiscectomy surgery is generally a very successful procedure, a hole is left in the outer wall of the disc. Patients with a large hole in the outer ring of the disc are more than twice as likely to reherniate after surgery. A new treatment, Barricaid, which is a bone-anchored device proven to reduce reherniations, was specifically designed to close the large hole often left in the spinal disc after microdiscectomy. In a large-scale study, 95 percent of Barricaid patients did not undergo a reoperation due to reherniation in the 2-year study timeframe. This treatment is performed immediately following the discectomy—during the same operation—and does not require any additional incisions or time in the hospital. 

If you have any questions about the Barricaid treatment or how to get access to Barricaid, ask your doctor or contact us today.

For full benefit/risk information, please visit: https://www.barricaid.com/instructions.