Laminectomy and spinal stability: a biomechanical rebuttal to patient alarmism

In contemporary clinical practice, there persists a troubling tendency among certain orthopaedic surgeons to incite fear regarding alleged “post-laminectomy instability.” This narrative, often unfounded, has led to a pathologization of operated anatomy and the overindication of unnecessary spinal fusions. The implications of such a trend are multifaceted: patients may be subjected to more invasive procedures than necessary, spinal biomechanics may be compromised long-term, and healthcare resources may be allocated inefficiently. This article offers a critical review of the alarmist perspective, contrasting it with the biomechanical principles established by Francis Denis and other authoritative voices. It delves into the anatomy and function of spinal columns, analyses the real impact of Laminectomy on structural integrity, and addresses the nuanced, often underexplored, issue of spinal fusion overuse. Through an evidence-based, clinically grounded approach, the work aims to promote a more balanced and discerning view of spine surgery indications, advocating for responsible, individualized decision-making over reflexive instrumentation