Laminotomy and laminectomy are two different types of spinal decompression surgeries that involve accessing the lamina of the spine. The lamina is a bony plate that covers the back of the spinal canal. The difference between these two different procedures is glaring. A laminectomy refers to an operation that totally removes the lamina. On the other hand, a laminotomy is simply the partial removal of the bone. Depending on the nature of your case, your spine surgeon may choose one or the other to gain access to the affected area that is causing neck or back pain, as well as any other neurological symptoms.
Two Methods With The Same Goal
Your doctor will have their reasons for performing one of these procedures over the other. The main goal regardless of the specifics of your case will be to create space around the spinal cord and surrounding nerves by removing structures that cause compression.
In some cases, these procedures may be performed because the lamina itself is the structure compressing your nerves. In other instances, your surgeon may need to remove parts of the lamina to gain access to other parts of the spine. A common example involves removing the lamina so that the surgeon may have a better view of a herniated or bulging disc.
When the spinal cord or a nerve therein becomes compressed, you may experience neurological symptoms such as numbness, weakness, and pins and needles sensations. Therefore, the goal is to decompress the affected neural structures in order to eliminate the unpleasant, associated symptoms.
What to Expect During a Laminectomy or Laminotomy
Both surgeries are performed using a posterior approach, meaning that you will be lying face down for the duration of the operation.
The surgeon will start by making an entry point incision near the affected area. Once the incision is made, the surgeon will then use a retractor to move the skin, fat, and muscles to the side. Doing so will allow your surgeon to avoid unnecessary damage to these structures during the procedure.
Next, your surgeon will then perform the appropriate procedure. He or she will make sure to the handle the damaged nerves that radiate from the spinal cord with care. Additionally—after removing part or all of the lamina—your surgeon will then remove all or part of the affected discs or bone spurs that cause the pinched nerve. At this point, your surgeon will now choose to do any number of other procedures, such as a foraminotomy or spinal fusion before closing the initial entry incision.
Procedures Performed in Conjunction With a Laminotomy & Laminectomy
Generally speaking, surgeons do not perform laminotomies and laminectomies at the same time. That being said, your surgeon may perform both if your condition affects multiple levels of the spine.
Your surgeon may perform the following surgeries in addition to these two operations:
- Foraminotomy: Like the two procedures detailed above, a foraminotomy involves decompressing structures within the spine. In this instance, instead of removing part or all of the bone, the surgeon accesses the affected area through the spine’s foramen (essentially a thoroughfare that the nerves pass through on both sides of each spinal disc).
- Discectomy:This is a very common surgery used to decompress a herniated disc via removing all or part of the affected disc.
- Spinal Fusion: Your surgeon will often perform fusion with spinal implants after decompression operations, as the space created from removing spinal structures may lead to instability in the spine. These implants will thereby ensure that the instability is eliminated accordingly.
Minimally Invasive Outpatient Options
Surgeons have historically performed these two procedures in a traditional open way. However, in recent times it is has become possible to approach these operations with a minimally invasive approach.
Doctors call minimally invasive versions of these procedures “microlaminectomies” and “microlaminotomies.” Like any minimally invasive procedure, these two versions are all about smaller incisions, which means less trauma to the surrounding muscles and tissues. Additionally, this also means less scarring and a speedy recovery.
Your doctor will be able to perform these procedures on an outpatient basis, usually in an ambulatory surgery center. Outpatient surgery provides the patient with much more comfort and convenience than traditional open surgeries. From beginning to end, an outpatient surgery generally takes around 45 minutes to complete.
The downside of these two minimally invasive options is that they are simply not a viable choice for everyone. Some patients have spinal problems that a surgeon cannot address by anything but traditional surgery. You will have to discuss your spinal disorder and health status with your doctor to determine whether or not this is the right choice for you, or if it is even an option to begin with. If your doctor already recommends a laminectomy or laminotomy, then you are automatically a candidate for the minimally invasive versions of these surgeries.
Is a Laminectomy or Laminotomy Right for Me?
Your surgeon can treat the following spine conditions with these two procedures:
- Spinal Stenosis: The narrowing of the spaces within the spine. This causes pressure on adjacent nerves that travel through the neural highway. Usually, this occurs in the lower back and in the neck.
- Herniated Disc: A disc is essentially a jelly donut of cushiony filling between the vertebrae. Sometimes, these structures will push through a tear in the vertebrae, leading to what doctors call a herniated disc.
- Sciatica: Usually, this starts with a herniated disc in the lower spine. When a disc wears down through years of use, the soft center pushes out from its hard shell. When a disc herniates, it may put pressure on the nerves surrounding it. One such nerve is the sciatic nerve. This nerve starts in the lower back and runs through the hips, buttocks, legs, and feet on both sides. When this happens, doctors call this sciatica.
- Degenerative Disc Disease: This occurs when normal changes that take place in the discs of the spine lead to pain. Spinal discs are flexible shock absorbers in the spine, allowing us to bend and twist. With age, these structures become worn and it shows. Everyone’s discs will break down eventually, but not everyone feels pain from this. Dry or cracked discs from overday use can cause this problem.
- .Spondylosis: Also known as osteoarthritis, this is essentially a type of degenerative disc disease—or rather—it is caused by degenerative disc disease. At its most basic level, spondylosis is basically just arthritis of the spine and it occurs from age-related wear-and-tear.
Do you have a debilitating spinal condition that is affecting your everyday life? Maybe you could do with one of the procedures in the article above. Or even better, maybe you could do with a conservative treatment plan. To find out what is best for you, please contact our practice at (973) 538-0900. The Advanced Spine Center is a multispecialty care facility that houses board-certified and fellowship-trained physicians who make use of only the most modern surgical management and cutting-edge treatments. With our team, you can rest assured that you’ll receive a care plan suited to your specific needs.