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Laminotomy

A procedure to relieve certain spine conditions at Laser Spine Institute

At Laser Spine Institute, we use an endoscopic approach to laminotomies to open up the spinal canal in an outpatient surgical setting. We do not perform laminectomies.

A laminotomy is a surgical procedure that is used to relieve pressure off the spinal canal for the exiting nerve root and spinal cord, increasing the amount of space available for the neural tissue and thus releasing the nerve(s).

The term laminotomy is derived from the Latin words lamina (bony plate that covers the posterior arch of the vertebra) and -otomy (act of cutting, incision).

A laminotomy of the spine is used to treat the following conditions:

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A laminotomy is also a procedure used to remove the ligamentum flavum, a ligament in the spinal canal that can thicken to the point where it is actually compressing on the spinal cord, attributing to spinal stenosis. Through a laminotomy, the ligament can be removed, therefore opening up the spinal canal and releasing the nerve(s).

Another type of surgery called a laminectomy is a procedure used in open back surgeries that involves removing the lamina to increase the amount of space available for the neural tissue. The term laminectomy is derived from the Latin words lamina (thin place, sheet, or layer), and -ectomy (removal).

During an endoscopic procedure, the surgeon places the first tube into a small incision. A series of tubes of increasing size are placed over this first tube, one at a time, to slowly create a small opening to the spine. That allows us to perform laminotomies with minimal damage to the surrounding muscles. The muscles are pushed out of the way and are not torn or cut. The last tube is about 18 millimeters in diameter (about as big as a small marker) and through this working tube we insert the laser, camera, suction, irrigation and other surgical instruments.

Once everything is in place, the surgeon can begin the procedure. Some patients feel immediate relief during the laminotomy as the nerve(s) are released. By decompressing the spinal canal the patient's symptoms of back and/or leg pain will resolve.

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When the procedure is complete, the tube is slowly removed, allowing the muscles to move back into place. Occasionally, a stitch or two is needed for the incision. After 1-2 hours of monitoring, the patient (with a companion) is free to go.

We generally encourage patients to take a long walk the afternoon or evening of their laminotomy procedure. The patient then returns the following day for a postoperative visit to get clearance from the doctor to return home.

Advantages of our endoscopic approach:

Laser Spine Institute offers various minimally invasive procedures to relieve neck and back pain caused by spine conditions and nerve conditions. Procedures offered include laminotomy, foraminotomy, endoscopic discectomy, facet thermal ablation, and fusion alternatives.