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Operating techniques
About the treatment
Microsurgery (conventional technique)
Procedure
The patient lies on his or her stomach under general anesthesia. The surgeon accesses the narrowed area of the lumbar canal, gently releasing the vertebral muscles. The compressed nerves are then decompressed under microscopic control using specialised instruments.
Steps and Benefits
- Compressed nerves are decompressed to relieve pressure in the canal.
- If necessary, implants (screws, rods, cages) stabilize the vertebrae.
- A drain can be inserted and removed on the second post-operative day.
- The technique provides effective nerve decompression, reducing symptoms and risks.
About the treatment
Mini-Invasive Surgery
Procedure
Lumbar laminectomy can be performed using a minimally invasive technique. The surgeon uses a tubular retractor to access the vertebral canal, avoiding the need to detach muscles from the spine. This approach minimizes damage to surrounding tissue.
Steps and Benefits
- The technique effectively releases compressed nerves, reducing pressure.
- Less bleeding, smaller scars and less post-operative pain.
- Intervention time less than 1 hour, with return home possible the next day.
- This approach reduces hospital stays and promotes rapid recovery.
About the treatment
Endoscopy
Procedure
Endoscopic surgery is an alternative to microsurgery and minimally invasive surgery. An incision of around 1 cm is made at the level of the stenosis, then a camera is introduced into the spinal canal, allowing the canal to be widened to decompress the nerves.
Steps and Benefits
- Effective technique for widening the canal and freeing compressed nerves.
- Less bleeding, smaller scars and reduced post-operative pain.
- The procedure is sometimes performed on an outpatient basis, with same-day return home.
- Minimally invasive procedure that reduces recovery time and hospitalisation.
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Hospitalisation
Microsurgery: 2 to 3 days in hospital.
Minimally invasive/endoscopic surgery: Ambulatory, get up after 2-3 hours.
On your return to your room, a physiotherapist will help you get up for the first time.
Return Home
Microsurgery: 3rd day after surgery.
Minimally invasive/endoscopic surgery: Same day.
Return home by private car or taxi/VSL.
Post-Operative Care
Microsurgery: Nursing care at home with daily anticoagulation and dressing changes every 2 days.
Sutures/staples removed after 12 days.
Minimally invasive/endoscopic surgery: No nursing care required, no dressings or staples.
Back to school or work
Microsurgery: Return to normal life 1 to 2 months after surgery.
Minimally invasive/endoscopic surgery: Return to normal life in 1 to 2 months.
Rehabilitation/ Physiotherapy
Start: 1 month (or earlier for minimally invasive/endoscopic surgery).
Duration: 1 to 3 months, depending on recovery.
Pace: At least 2 weekly sessions (30-60 min), ideally 3, with daily exercises.
Nature: Pain-relieving physiotherapy, muscle strengthening, relaxation, posture.
No need for corset/lumbar belt except in special cases.
Neurological complications: Less than 5%.
Neurological complication: Less than 5% Risk of neurological aggravation, including neuropathic pain or temporary or permanent paralysis. This risk is less than 5%.
Infection: Less than 1%
Scar infection may require a return to the operating room for cleaning and prolonged antibiotic therapy.
Chronic or late infections may require reoperation to remove or change the implanted material.
Bleeding complications
Significant bleeding during or after the operation may require transfusion.
In the event of compressive post-operative hematoma (pain/neurological deficit), urgent revision surgery will be performed.
Breche Durale
If the dura mater is damaged, it will be repaired. The patient will have to remain in bed for 48 hours, with a prolonged hospital stay of several days.
Risk of new narrow lumbar canal: 10 to 15%.
A patient operated on for a narrow lumbar canal may develop a new narrowing at another level of the spine.
This progressive degeneration may require further surgery to decompress another segment of the spinal canal.
FAQ
Answers for our patients
If you have any further questions, please do not hesitate to contact us.
How can I make an appointment?
You can book an appointment directly on our website or by telephone on 04 72 43 03 43 (choice 1).
How long does it take to get an appointment?
Appointments take around 1 to 2 months. In an emergency, your GP can contact us directly by email.
How does the first consultation work?
At your first consultation, you will complete an iPad questionnaire in the waiting room so the doctor has your information in advance. The consultation will then determine whether surgical or non-surgical treatment is needed.
What documents should I bring to my visit?
Please bring your carte vitale, your GP's referral letter, and any radiological examinations already carried out.
