Laminectomy/Laminotomy
A laminectomy is a type of decompression surgery that relieves pressure on the spinal cord and exiting nerves by enlarging the spinal canal. During this procedure the lamina is removed along with a portion of the enlarged facet joints and thickened ligaments overlying the spinal cord and nerves.
Two bilateral laminae are located the back portion of each vertebra. They are the part of the vertebral bone that forms the vertebral arch or posterior roof of the spinal canal through which the spinal cord travels.
When the spinal canal narrows due to deterioration of the spinal column, pressure on the spinal cord and nerve roots develop. This narrowing of the spinal canal is known as spinal stenosis and this condition can give rise to symptoms of pain and other neurological dysfunction. In some cases of spinal cord compression myelopathy can develop, producing sensory changes and weakness in both extremities, a loss of coordination, and incontinence in bowel/bladder function.
A surgical procedure known as a laminectomy may be recommended when conservative therapy has failed to provide relief, when symptoms interfere with daily life, or if the spinal cord is at risk of permanent injury. The goal of the procedure is to relieve pressure on the nerve roots and the spinal cord, as well as to help the surgeon gain better access for treating other spinal damage, such as a herniated disc or bone spurs.
In the process of “unroofing” the spinal canal with a laminectomy, enlarged ligaments along the back of the spine are removed. Arthritic facet joints may also be shaved to provide more room for exiting spinal nerves. In conjunction with a laminectomy additional surgical procedures may be performed to further relieve nerve pressure, remove excess or damaged tissue, and provide stability to the spine. Contingent upon the extent of the spinal stenosis one or more vertebrae may required the laminectomy procedure. In suitable cases, a laminotomy, or removal of only a portion of the lamina that is causing the impingement of a nerve is possible.