Laminotomy
Laminotomy is a surgery in which the aim is to remove part or most of a spinal bone called the lamina. The lamina is the back part of each vertebra (spinal bone) and covers the spinal canal, the area around the spinal cord. In a laminotomy, your doctor makes a hole in the lamina and removes a small piece of the bone.
The procedure allows your doctor to see irritated spinal nerves. The doctor can remove anything pressing on spinal nerves that are causing arm or leg pain, such as bone spurs, herniated discs, tumors, or overgrown ligaments. The procedures also may ease back or neck pain. They won’t eliminate pain caused by arthritis or wear and tear on spinal joints. It can be done anywhere on the spine. More than one vertebrae may be treated. The risk of complications is low. Patients typically spend one or two days in the hospital afterward.
Laminotomy is a procedure performed by spine surgeons to decompress the spinal canal in either the cervical (neck) or lumbar (low back) spine. Laminotomy typically refers to a unilateral (left- or right-sided) approach to this type of spine surgery. This is one of the most common operations performed by spinal surgeons. Laminotomy surgery can help relieve pressure on the spinal cord caused by spinal stenosis (narrowing of the spinal canal).
Lumbar laminotomy is typically used to treat: lumbar stenosis, neurogenic claudication, and radiculopathy.
Surgery
Here is what a patient can expect during a laminotomy surgery:
- The patient is placed face down on a specialized surgical table under general anesthesia.
- The surgeon will then identify the problem area of the spine using an X-ray.
- Next, a small incision is made on the back and the muscles are either lifted off the bone (open surgery) or gently moved apart using a tubular retractor (minimally invasive surgery) to gain access to the spine.
- Once the spine has been accessed, a high-speed burr (drill) is utilized to create a hole in the lamina (the portion of the bone that covers the back of the spinal canal).
- The ligamentum flavum (ligament of the spine) is then lifted up off the spinal cord. Oftentimes, with age and arthritis, the ligament becomes excessively thick and hard, creating significant pressure and stress on the spinal nerves.
- The surgeon then decompresses one or both sides if needed to ensure that any bone or material causing compression is removed up to the spinal cord and nerve roots.
How a Laminotomy Works
Laminotomy surgery works by removing the overgrown bone or ligament (ligamentum flavum) that is causing compression. It increases the space surrounding your spinal cord and ensures the spinal fluid that flows around your spinal cord has more room to flow normally. By relieving the pressure, your nerves have more room and are in a better environment to heal as the inflammation settles down. Having laminotomy surgery typically translates to significant relief of symptoms such as pain and weakness.
Benefits
Laminotomy can be done via minimally invasive methods with small incisions and the aid of a microscope. Because it involves less muscle disruption, recovery tends to be faster, with shorter hospital stays and quicker returns to work and normal function. It allows your surgeon to directly remove any offending agents and directly visualize your nerve roots to ensure they are well decompressed. Because it does not involve a fusion, there is no compromise in flexibility or range of motion.
Recovery
Recovery and prognosis for laminotomy are excellent. Greater than 95% of patients have laminotomy on an outpatient basis and return home the same day as surgery. You may experience two to three days of low-grade pain at the site of the incision, which is treated with pain medicine. After laminotomy, most patients quickly experience complete relief from back and leg symptoms. Most people completely recover in about three to six weeks with physical therapy. It is common to have infrequent tingling, numbness, or shooting pains after surgery, which typically improve with time and physical therapy as the nerve continues to heal. Generally, patients are encouraged to walk as much as possible in the first month, but to avoid bending, twisting, or lifting greater than 15lbs. You start physical therapy at around 4 weeks and typically return to normal activity by 3-4 months.
Cost
The cost of laminotomy is based on several considerations. This can include both the extent of the procedure and a patient’s insurance carrier. Medicare can cover this procedure if it is deemed necessary treatment. BEST accepts Medicare, most private health insurances, and works with workers’ compensation claims and personal injury cases at all of our centers.
Reach out to BEST Health System Today
To learn more about laminotomy and if it is right for you, contact BEST Health System today. Our caring and experienced team of treatment professionals can help you develop a personalized treatment plan that is right for you. We are dedicated to getting you the quality of life you deserve.
Procedure Doctors
Jeffrey Shall, M.D.
Neuropathy Specialist & Spine and Orthopaedic Surgeon
Advanced Orthopedics & Physical Therapy
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