A laminotomy is a minimally invasive procedure that deals with removal of the lamina, the flattened or arched part of the vertebral arch. A board certified spine surgeon creates a small hole above the spinal nerve. The surgeon removes a portion of the lamina in smaller parts on one or both sides of the spine creating small holes between the laminae to decompress the spinal cord.
The most common reason for a laminotomy is spinal stenosis. Spinal stenosis occurs over time when the ligaments between the lamina thicken and the facet joints enlarge. Facet joints are located between and behind adjacent vertebrae. Sometimes, bone spurs will form and pinch a nerve. A person can also be born with a small spinal canal, a condition known as congenital spinal stenosis. The pressure on these nerves can worsen when performing movements like standing or walking, causing increased pain in the back and legs.
A small incision is made in the back near the affected area. Once the lamina have been exposed, a microscope can be used to examine.
Bone removal will be minimal to help minimize the effect on the spinal column. The surgery takes approximately an hour per spinal level, depending on the severity of the stenosis.
With this surgery from Orlando Orthopaedic Center, patients typically go home the same day with recovery lasting four to six weeks.
Who is a Candidate for a Laminotomy?
Ideal candidates for laminotomy may have different spinal conditions, but most will experience narrowing of their spinal canal. Candidates experience one or more of the following symptoms:
- Acute or chronic pain in the neck or back that is dull, sharp, throbbing, deep, shooting, or radiating to the extremities
- Sciatica pain that radiates from the back down to the buttocks, legs, calves, feet, and/or toes
- Pain in the neck that radiates into the shoulders, arms, hands, and/or fingers
- Weakness, numbness, or a tingling sensation felt in the extremities
- Limited motor functions
- Difficulty standing straight, walking, or sitting
- History of attempting conservative methods of treatment that have been unsuccessful in significantly relieving pain
All risks and benefits of spine surgery should be considered before making a decision. The spine surgeon will discuss all available options and treatments.
What to Expect Following a Laminotomy
Some patients may go home the same day after the surgery, although in some cases, a short hospital stay is required. The spine surgeon may recommend physical therapy after a laminotomy to improve strength and flexibility. It’s recommended patients limit activities involving lifting, bending and stooping for several months after their laminotomy.
Most patients experience a significant reduction in the leg pain not long after completion of the procedure. Pain at the incision site and the spasms of the back muscle are common but resolve within a week or two of the surgery. After a laminotomy, patients may wear a low back brace for a period of two to five months. Patient may perform physical therapy for 3 to 5 days until fully recovered.