Spinal Case – Keyhole lumbar laminectomy

Spinal Case – Keyhole lumbar laminectomy

Patients with spinal stenosis usually present with symptoms of neurogenic cluadication, with bilateral leg pain with walking and standing. A CT or MRI will often make the diagnosis.

Surgery is the appropriate treatment and the traditional METRxoperation is a decompressive lumbar laminectomy at the affected levels. The commonest level to be affected is at L4/5, and a normal surgical approach would usually require a midline incision of 10-15 centimetres. Patients would often take several days, sometimes up to a week, in hospital to recover.

An alternative is do this procedure using keyhole techniques. In this way, the decompression can be done via a tubular retractor, inserted via a small paramedian incision.

There is much less musclar disssection but the neural decompression is just as effective. Patients often leave hospital the next day or 2 after surgery.

A 77 year-old man presented with bilateral leg pain on walking and standing. His MRI scan showed a tight stenosis at L3/4 due to degenerative changes, with an associated synovial cyst of the right L3/4 facet joint. He proceeded to surgery, and a keyhole L3/4 decompression was performed, approached from the right hand side of L3/4. See scans below (click images to enlarge).

His symptoms were immediately relieved and he left hospital 48 hours after surgery. A postoperative CT scan showed the effective decompression, including of the central canal and the left side.


– By Prof David Walker



Patient and staff safety is our highest priority at Briz Brain & Spine.

For patients with appointments, if you are suffering any symptoms such as fever, dry cough, sore throat, tiredness or shortness of breath or have recently travelled interstate, overseas or been in contact with someone who has returned from interstate or overseas, or have been in contact with a confirmed case of COVID-19, please contact our friendly reception team before attending the clinic. A telehealth appointment may be an alternative method of speaking with our surgeons.

Protecting the health of our staff is vital to ensure they can continue to provide great service.  Patients are encouraged to prepay accounts over the phone prior to appointments or via payWave or other contactless payment methods. Patients are also asked to complete the Patient Details Form and sign the Privacy Policy Agreement electronically prior to their appointment. These forms can be found under our Contacts page on the website or by clicking here. Please note, patients are asked to bring only ONE support person to their appointment and maintain appropriate social distances to help reduce the risk of Covid-19 transmission.

During this current outbreak of Covid-19 coronavirus we want to assure all of our patients that we will continue to implement procedures to maintain a hygienic clinical environment. This includes:

-          Disinfecting and wiping down all treatment surfaces

-          Regular cleaning of rooms and shared equipment

-          Thorough cleaning of all communal items including reception chairs, tables, door handles, pens and other shared items

-          All staff have access to infection control procedures and training to implement these as necessary

We are carefully monitoring the directions and advice of Queensland Health, the Australian Government Department of Health and the World Health Organization. In the meantime, it is still business as usual and our doors are open.

Briz Brain & Spine wishes to apologise for the inconvenience caused and thanks you for your cooperation and understanding during this unprecedented situation.