A number of crucial nerves and the spinal cord itself pass through the spinal canal en route to their final destination, and so long as this spinal canal opening remains large enough, these nerves can pass unimpeded. However, as we get older and our spine experiences some natural degeneration, this passage can narrow and compress these key structures, causing pain and a host of other symptoms. When this happens, a minimally invasive decompression operation may be able to provide relief.
There are a few different operations that can be performed to address spinal canal narrowing, but two of the most common are the laminectomy and the laminotomy. They both sound similar, and they share a number of the same characteristics, but they also differ in a few important ways. In today’s blog, we take a closer look at similarities and differences between a laminectomy and laminotomy procedure for spinal nerve decompression.
Comparing Laminectomy And Laminotomy
To better understand the procedures, we first must learn a little more about the anatomy of our spine. Your lamina is part of your vertebral column that acts as the roof of your spinal canal and provides support and protection for the spinal cord and nerves that pass through the area. Removing some or all of this part of the vertebrae creates more room for the spinal cord and nerves to pass through the area.
A laminectomy and laminotomy procedure each have the same underlying goal, which is to create more space for the spinal nerves, but they achieve this goal in slightly different manners. With a laminectomy, the entire lamina is removed in order to access the area and ensure nerves can pass through freely. In a laminotomy, only a portion of the lamina is removed in order to achieve the same result. Here’s a little more information about both procedures:
- Laminotomy – Using minimally invasive techniques, the surgeon removes a 3-4 millimeter window in the lamina to provide more space for the nerves. This is generally reserved for more isolated instances of nerve compression, like if you have a moderate disc herniation or a specific area where bone spurs are irritating spinal nerves.
- Laminectomy – If the damage to spinal nerves is greater or compression is more significant, the patient may benefit from a laminectomy procedure where the entire lamina is removed and more space is created. Again, this can be accomplished using minimally invasive techniques, but surgeons need to be mindful of how such a large removal could impact the stability of the spinal column. These procedures are carefully planned and typically reserved for severe disc herniations, large bone spurs or enlarged synovial cysts that cannot easily or permanently be addressed with other methods.
Both operations begin in a similar manner, with the patient lying on their back on the operating table before being given anesthesia. The surgical team then carefully rolls the patient onto their stomach and makes a small incision along the spine above the area of compression. The surgeon then carefully moves muscles and other tissues out of the way to access the surgical site. The surgeon then carefully removes a portion of the lamina or they remove the spinal process, which allows the surgeon to remove the entire lamina. Both procedures are conducted using a microscope and specialized surgical equipment.
After the lamina has been addressed and the surgeon ensures the nerves can pass through the area freely, spinal muscles are repositioned and the incision site is closed with absorbable sutures. Patients are then taken to a recovery area where they will come out of anesthesia and meet with their care team. Assuming all went as planned, most patients can leave the surgical center on the same day, so long as they have someone else there to drive them home.
For more information about either procedure, or to talk to a specialist about your new or chronic back pain, reach out to Dr. Jackman and the team at The Midwest Spine & Brain Institute today.
