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What is Laminectomy vs. Laminotomy?

Laminectomy and laminotomy are surgeries performed on the spine to decompress or remove pressure on the spinal cord and/or nerve roots by accessing the lamina, a bony plate that covers the back of the spinal canal. These surgeries are known as spinal decompression surgeries and are quite similar in nature; the only difference is how the lamina is approached. A laminectomy refers to the complete removal of the lamina. On the other hand, a laminotomy refers to partial removal of the lamina. The objective of both surgeries is to create space around the spinal cord and surrounding nerves by removing a segment or the whole lamina that is causing compression.

Indications for Laminectomy vs. Laminotomy

Although a laminectomy and laminotomy are two separate methods, the objective of both surgeries is to create space around the spinal cord and surrounding nerves by removing a segment or the whole lamina that is causing compression. When the spinal cord and/or nerve(s) are compressed, you may experience physical and neurological symptoms down the nerve’s pathway into a limb, such as:

  • Radiating pain
  • Numbness
  • Weakness
  • Tingling
  • Electric shock-like sensations

A spine surgeon may recommend a laminectomy or laminotomy for spinal disorders causing spinal cord and/or nerve root compression, such as:

  • Herniated disc
  • Spondylosis
  • Degenerative disc disease
  • Sciatica
  • Spinal stenosis

Preparation for Laminectomy vs. Laminotomy

In general, preoperative preparation for laminectomy or laminotomy may involve the following:

  • A review of your medical history, routine blood work, imaging, and other tests specific to your condition
  • Informing your doctor of any medications or supplements you are taking
  • Informing your doctor of any allergies to medications, anesthesia, or latex
  • If you are on certain medications, such as blood thinners, you may be asked to temporarily stop them as it may affect blood clotting
  • Refraining from solids or liquids at least 8 hours prior to surgery
  • Arranging for someone to drive you home after the procedure
  • Signing an informed consent form after the pros and cons of the surgery has been explained

Procedure for Laminectomy vs. Laminotomy

Laminectomy and laminotomy can be performed in different areas of the spine, most commonly the cervical spine (neck area) and lumbar spine (lower back area). Both surgeries are performed using a posterior approach, meaning that you will be lying face down for the duration of the operation usually under the influence of general anesthesia. Your surgeon makes a mid-line incision over the area of the spine requiring decompression. Special equipment such as retractors and dilators are used to separate the muscle tissue to access the lamina. Your surgeon then removes all or a section of the lamina to relieve the pressure on the nerve root and/or spinal cord. Other compression sources such as bone spurs, thickened ligament tissue, or all or part of a disc, may also be removed. Your surgeon returns the soft tissue and muscles to their normal position and closes the incision with stitches or surgical staples.

Postoperative Care and Recovery

After the surgery, you will be transferred to the recovery area where your nurse will closely monitor your vital signs as you recover from the effects of anesthesia. You may feel pain and discomfort in the operated area. Medications are provided as needed to address this. A soft collar or back brace may be prescribed for spine support and comfort and to limit movement of the spine. Physical therapy focusing on the spine will be started 4 to 6 weeks after surgery and involves stretching and range-of-motion exercises to improve strength and mobility. Instructions on surgical site care and bathing will be provided to keep the wound clean and dry. You should avoid strenuous exercise or activities such as lifting, bending, or stooping for about six weeks. A follow-up appointment will be scheduled to monitor your progress.

Risks and Complications

Laminectomy or laminotomy are relatively safe procedures; however, as with any surgery, some risks and complications may occur, such as the following:

  • Infection
  • Bleeding
  • Blood clot formation
  • Nerve or tissue damage
  • Dural puncture
  • Spinal segment instability
  • Adverse reactions to anesthesia
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