A lumbar laminotomy and laminectomy are two types of spinal decompression surgical procedures that involve your vertebrae’s lamina, the arch of bone that protects the spinal cord. A laminotomy is the partial removal of the spine’s lamina, while a laminectomy is the complete removal of the spine’s lamina. The purpose of these procedures is to relieve pressure on the spinal cord or nerves, usually in the lower back or lumbar area.
Who is a Good Candidate?
Lumbar laminotomies and laminectomies are most often performed on patients who suffer from spinal stenosis. Spinal stenosis involves narrowing of the spinal canal, placing pressure on the spinal cord and causing pain, numbness, and weakness in certain parts of the body. A large portion of patients respond well to non-surgical treatment, but severe symptoms may qualify you for surgery, such as:
- Lack of bowel or bladder control
- Worsening leg weakness
- Presence of infection or abscesses in the spine
- Inability to walk or move for long periods of time
- Presence of tumor in or near the spine
- Diagnosis of a herniated disc
What to Expect Before Surgery
If you are good a candidate for a laminotomy or a laminectomy, you should prepare by following standard surgical protocols:
- Fill out adequate paperwork, including consent forms and medical history
- Complete all pre-surgical tests, such as blood tests, X-rays, electrocardiograms
- Stop taking blood thinners seven days before surgery
What to Expect During the Procedure
Your procedure may be open or minimally invasive, depending on your spinal disorder, how many vertebrae need to be treated, and other factors. In general, a minimally invasive laminotomy is the preferred procedure due to its smaller incisions, less damage to the surrounding tissues, and ability to spare some bone. However, you may need a laminectomy in cases of severe compression.
During a laminotomy procedure, your surgeon will make a hole in the lamina and take out a small piece of bone, while in a laminectomy procedure, your surgeon will remove a majority of the lamina.
In both types of procedures, your surgeon will also remove any ligaments that have thickened and are compressing the nerves, along with bone spurs, disc fragments, or other elements that may be contributing to nerve root compression. If necessary, a spinal fusion can also be completed at the same time as this procedure.
What to Expect Following Your Procedure
Regardless of what type of decompression procedure you have, your recovery from a laminotomy and a laminectomy can take some time. Most patients will stay in the hospital for at least one night. After leaving the hospital, our surgeons at Spine Care Partners recommend to:
- Begin physical therapy within a week or two
- Keep your incision site dry
- Limit activities for several weeks, especially ones with bending, stooping, or lifting
- Avoid sitting for long durations of time
Your surgeon will also likely prescribe pain medications to help alleviate any discomfort in your back following the procedure.