Lumbar Decompression and Instrumented Fusion

  • Robert A. Dunsmuir
  • Antony L. R. Michael


  • Laminectomy is the removal of the lamina of the vertebra for purposes of decompression of the spinal canal.

  • It is combined with variable amounts of bone removal from the posterior elements such as the facet joints to adequately decompress the thecal sac and the nerve roots.

  • The ligamentum flavum which runs from the anterior aspect of the cephalad lamina to the superior aspect of the caudal lamina is also usually resected.

  • Laminectomy may be done at one or more levels. It is combined with instrumented posterolateral fusion in cases where there is instability of the spinal column as a result of the pathology being treated or where instability will be produced due to the amount of bone that needs to be removed for adequate decompression.


Pedicle Screw Spinal Canal Facet Joint Ligamentum Flavum Posterior Element 
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Further Reading

  1. Soegaard R, Bünger CE, Christiansen T, et al. Circumferential fusion is dominant over posterolateral fusion in a long-term perspective: cost-utility evaluation of a randomized controlled trial in severe, chronic low back pain. Spine (Phila Pa 1976). 2007;32(22):2405–14.CrossRefGoogle Scholar
  2. Han X, Zhu Y, Cui C, et al. A meta-analysis of circumferential fusion versus instrumented posterolateral fusion in the lumbar spine. Spine (Phila Pa 1976). 2009;34(17):E618–25.CrossRefGoogle Scholar
  3. Peng CW, Yue WM, Poh SY, et al. Clinical and radiological outcomes of minimally invasive versus open transforaminal lumbar interbody fusion. Spine (Phila Pa 1976). 2009;34(13):1385–9.CrossRefGoogle Scholar
  4. DiPaola CP, Molinari RW. Posterior lumbar interbody fusion. J Am Acad Orthop Surg. 2008;16(3):130–9.PubMedGoogle Scholar
  5. Ozgur BM, Aryan HE, Pimenta L, et al. Extreme Lateral Interbody Fusion (XLIF): a novel surgical technique for anterior lumbar interbody fusion. Spine J. 2006;6(4):435–43.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2011

Authors and Affiliations

  1. 1.Department of Trauma and Orthopaedic SurgeryLeeds Teaching Hospitals NHS TrustLeedsUK
  2. 2.Department of Trauma and OrthopaedicsLeeds Teaching Hospitals NHS TrustLeedsUK

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