Degenerative narrowing of the canal compresses the spinal cord or the nerve roots and, in the lower back, causes the typical walking claudication.
Frequently asked questionsRemoval of the posterior arch when compression is extensive and a more conservative technique is not possible.
It is the classic, highly effective technique, but it removes structures that provide stability, so I now reserve it for cases where it is unavoidable.
When it compromises the stability of the segment, it is combined with fusion using implants and bone graft.
The posterior arch, the piece of bone that closes the canal at the back. It is the classic technique and it is highly effective at freeing the nerve, but it removes structures that give the segment stability.
Because many cases of stenosis can be solved by removing only what compresses — recalibration and micro-foraminotomies — or by widening the canal indirectly. If the same result can be achieved while preserving structure, there is no reason to take it away. Laminectomy is left for cases where it is unavoidable.
It is not automatic. A fusion with implants and bone graft is added when the removal compromises the stability of the segment. How much has to be taken away, and therefore whether fusion is needed, is part of the planning and is discussed beforehand.
In multilevel cervical stenosis there is an alternative that avoids removing the arch: laminoplasty, in which the arch is repositioned and fixed to give the spinal cord room instead of being taken out.
The information on this page is for guidance only and does not replace a personalised medical assessment. Whether any technique is indicated depends on each patient's examination and scans.
I review your scans and tell you frankly which option makes sense, including not operating.