Laminotomy with Posterior Element Decompression

Laminectomy and laminotomy are two surgical procedures performed on the section of a spinal bone called the lamina. Laminectomies involve removal of most or all of the lamina, while laminotomies involve removal of only a minor segment of the lamina. Both procedures are performed to relieve excessive pressure on the spinal cord or its associated nerve roots.

Lamina Anatomy

Each of your spinal bones (vertebrae) has a flat, oval-shaped main body and a rear section that roughly resembles a pair of outspread wings. The rear portion of the main vertebral body forms the front wall of the spinal canal, while the various structures in the rear section form the rear and sides of the canal. Your lamina sits in the middle of this rear section and forms the rear wall of the canal, also known as the canal “roof.”

Laminectomy and Laminotomy Basics

Laminectomies and laminotomies are major procedures that require the use of general anesthesia. At the start of both procedures, your surgeon will use a scalpel to make an opening called an incision, then push aside the deeper tissues of your back or neck and expose the targeted vertebra. In the case of a laminectomy, he will then remove all or most of the lamina, as well as a segment of the vertebra called the spinous process, which sits on the rear portion of the lamina. In the case of a laminotomy, he will make a hole in the lamina or remove a small laminar segment.

Laminectomy and Laminotomy Uses and Benefits

Spinal problems that can lead to abnormal nerve or spinal cord pressure and trigger the need for a laminectomy or laminotomy include abnormal narrowing of your spinal canal, herniated or ruptured spinal discs, degenerated spinal discs and the formation of scar tissue in the aftermath of another back procedure. In some cases, performance of a laminectomy or laminotomy is enough to reduce damaging spinal pressure and ease your symptoms. In other cases, your surgeon will need to perform an additional procedure to fully address the source of your problems. For instance, during a laminectomy, your surgeon creates a large enough space to remove all or part of a damaged spinal disc, as well as bone spurs or any other material that’s intruding upon nervous system tissue.

In addition to decompression and/or removal of damaging material, you may undergo a laminectomy as part of treatment for problems such as spinal cord tumors or other diseases that afflict your spinal cord or spinal canal. Typically, surgeons try to perform laminotomies whenever possible, since they cause less physical trauma than laminectomies.

Laminectomy and Laminotomy Risks

The most common after effect of a laminectomy or laminotomy is significant pain at the site of the surgery. General risks associated with any surgical procedure include bleeding, blood clots, infections, poor reactions to anesthesia, breathing difficulties, strokes and heart attacks. More specific risks associated with laminectomies, laminotomies or any other form of spinal surgery include damage to your spinal cord or spinal nerves, spinal bone infections, leakage of cerebrospinal fluid, failure to sufficiently relieve your spinal problems and recurrence of those problems at some point in the future. Other than post-surgical pain, complications from the procedures are relatively rare.

 

References

MD Guidelines: Laminectomy or Laminotomy
U.S. National Library of Medicine – MedlinePlus: Laminectomy
Mayo Clinic: Laminectomy (Pages 1-3, 5 and 6)
Oregon Health & Science University: Laminotomy
Cedars-Sinai: Vertebrae of the Spine