Laminotomy and laminectomy are surgical procedures where a spinal bone, called the lamina, is partially or nearly totally removed, respectively. This bone is often described as the “roof” of the spinal canal, and the procedures can be thought of as unroofing the spinal canal. The procedures decompress the spinal cord or the nerves that are compressed by abnormal structures surrounding the spinal canal.
A laminectomy is when a majority of the lamina is removed, and a laminotomy makes a hole in the lamina and removes only a small portion of the bone. These two procedures allow a surgeon to see both the pathology and the nerves and are used to remove bone spurs, herniated discs, tumors, and overgrown ligaments that cause arm or leg pain by compressing the nerves in the spinal canal.
Surgeons perform laminotomies whenever possible, because it requires a smaller incision and is less damaging to the muscles surrounding the bone. Many surgeons use a microscope or magnifying glasses during this procedure to have a better view of the nerves. If the small hole in the lamina is not sufficient to free the nerves, surgeons will perform a laminectomy.
The disadvantage of the laminectomy is that the procedure strips more muscle away from the bone and removes more bone. However, the surgeon has a better view of the nerves and can decompress the spinal cord or nerves to a greater extent. Many patients worry that the “removal of the roof” will leave spinal nerves uncovered and unprotected. However, the nerves are still well protected after the surgery by the muscle and the spinal joint which surrounds the spinal canal. Laminectomies are typically performed to treat lumbar spinal stenosis, while laminotomies are commonly used to remove herniated discs.
These are two of the most versatile spinal surgeries because they can be performed at any level of spine from the top of the neck down to the pelvis. They have a relatively low risk of complications, and patients are typically only hospitalized for one or two days. These procedures are effective in relieving arm or leg pain, but they don’t entirely relieve back or neck pain. The back or neck pains are due to arthritis or the “wear and tear” of the spinal joints and not the compression of the nerves.
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