Laminotomy and laminectomy are surgeries to remove a spinal bone called the lamina. The lamina is the back part of the vertebrae (bones) covering the spinal canal (area around the spinal cord).
A laminotomy makes a hole in the lamina and removes a small piece of the bone. A laminectomy removes most of it. Taking this bone out reduces pressure on the spinal cord or spinal nerves. This relieves pain. Laminectomies are usually done to treat lumbar spinal stenosis (narrowing of the spinal canal). Laminotomies are often used to remove herniated discs.
Doing a laminotomy or laminectomy allows your doctor to see the irritated spinal nerves and anything that is pressing on them and causing pain. During surgery, the doctor can remove bone spurs, herniated discs, tumors and overgrown ligaments that cause arm or leg pain by pressing on spinal nerves. These procedures relieve arm or leg pain, but don’t completely relieve back or neck pain. The back or neck pain is caused by arthritis or wear and tear on your spinal joints, not pressure on the spinal nerves.
If possible, your doctor will do a laminotomy (remove some bone) instead of a laminectomy (remove most of the bone). A laminotomy has a smaller incision and is less damaging to the muscles around the bone. Your doctor may use use a microscope or magnifying glasses to have a better view of the nerves. If the small hole in the lamina is not enough to free the nerves, your doctor can do a laminectomy.
The disadvantage of the laminectomy is that the procedure strips more muscle away from the bone and removes more bone. However, your doctor can see the nerves better and remove more material that is pressing on them and causing pain.
You might worry that removing the lamina leaves your spinal nerves unprotected. But these nerves are still well protected by the muscles around your spine and the spinal joint around the spinal canal.
Your doctor can do a laminotomy or laminectomy anywhere on the spine. The risk of complications after surgery is low. After a laminotomy or laminectomy, you stay in the hospital for one or two days.