There are two primary surgeries with the aim of spinal decompression to relieve nerve pain related to a spinal disorder, but here we will focus on laminotomy spinal surgery.
To help educate patients who may need a laminotomy, we will discuss the types of spine surgery, the procedure itself, and why it is performed.
What is a Laminotomy?
A laminotomy is a spine surgery to remove a small part of a bony area of the spine called the lamina, which is the back part of each vertebra and together forms the back wall of the spinal canal. The spinal cord runs through the spinal canal in the center of the vertebra and certain conditions can compress the cord, causing pain.
The laminotomy procedure is a common spinal operation, but is considered major surgery and should be pursued after less invasive treatments have been explored. It’s also important to note that laminotomy is often used interchangeably with laminectomy, but these are different operations that only have the lamina in common. A laminectomy removes most of the lamina while the surgery being discussed here only removes a small part.
What Does a Laminotomy Treat?
A laminotomy is used to treat specific diseases and conditions of the spine, often as one of the last recourses if less invasive procedures or treatments have been ineffective. While a laminotomy is aimed at relieving the pressure of the spine, they are typically recommended when a patient suffers from spinal cord compression with symptoms of myelopathy. Myelopathy is an impaired function of the spinal cord due to it being compressed and the symptoms include pain, numbness, weakness, poor balance, difficulty walking, stiffness in the limbs, and clumsiness. Other conditions the surgery may be recommended for include:
- Bone spurs: abnormal growths of bone on the vertebra
- Herniated spinal disc: displacement of the cushioning disc between vertebrae
- Sciatica: pain that runs down the buttock and leg from compression of a nerve in the lower back
- Spinal stenosis: a narrowing of the spinal column which causes pressure on both the spinal cord and nerves.
Types of Laminotomy
There are several versions of the surgery based on the area of the spine the procedure is being performed on and two categories, single level and multilevel. A single level involves one vertebra and the multilevel involves more than one vertebra, both classifications apply to the versions below:
- Cervical: the removal of part of the lamina in the neck area, or cervical spine.
- Lumbar: the removal of part of the lamina in the lower back, or lumbar spine.
- Sacral: the removal of part of the lamina in the back between the pelvic or hipbones, the sacral spine
- Thoracic: the removal of part of the lamina in the middle of the back, or thoracic spine.
The operation is performed at a hospital or surgical center and there are two primary approaches to the surgery:
- Microlaminotomy: a minimally invasive procedure where special instruments and an arthroscope are inserted into the back or neck. This technique leads to a faster recovery and less pain than open surgery because there is less damage to tissue and organs.
- Open surgery: a large incision is made into the patient’s back over the affected vertebra and the length depends on how many vertebrae require treatment. Open surgery allows the surgeon to see directly into and access the surgical area. This technique leads to a longer recovery and more pain due to the larger incision and more displacement of muscle, and other tissue.
On the day of the surgery, a patient can expect:
- A conversation with the nurse and/or surgeon, they will perform an exam to ensure you’re able to undergo the procedure.
- A conversation with the anesthesiologist about your medical history and the type of anesthesia being administered.
- The surgical team begins the IV and the anesthesia is administered.
- A tube is placed into the patient’s windpipe to protect and control breathing during the anesthesia, this won’t be felt or remembered.
- During the procedure, the team will monitor vital signs and critical bodily functions to ensure a safe procedure.
- Following the operation, the patient will remain in a recovery room till awake and the care team will likely have the patient sit up and walk.
- While a laminotomy is an outpatient procedure, it isn’t uncommon for a longer hospital stay.
At Proliance Puget Sound Orthopaedics, we provide best-in-class orthopedic care to our community with compassion, caring, and dedicated expertise for spine surgery. If you’re suffering from or need treatment for spinal conditions, we encourage you to call (253) 830 – 5200 or request an appointment online to see one of our physicians.