Lumbar Laminotomy

Laminotomy is a procedure performed by spine surgeons to decompress the spinal canal in either the cervical (neck) or lumbar (low back) spine.

Laminotomy typically refers to a unilateral (left- or right-sided) approach to this type of spine surgery. This is one of the most common operations performed by spinal surgeons.

Laminotomy surgery can help relieve pressure on the spinal cord caused by spinal stenosis (narrowing of the spinal canal).

Spinal stenosis may cause symptoms such as pain or numbness in the legs, weakness and balance problems.

Lumbar laminotomy is typically used to treat:  lumbar stenosis, neurogenic claudication, radiculopathy.

Having Laminotomy Surgery

During laminotomy surgery, the patient is placed face down on a specialized surgical table under general anesthesia.  

The surgeon will then identify the problem area of the spine using X-ray.

Next, a small incision is made on the back and the muscles are either lifted off the bone (open surgery) or gently moved apart using a tubular retractor (minimally invasive surgery) to gain access to the spine. 

Once the spine has been accessed, a high-speed burr (drill) is utilized to create a hole in the lamina (the portion of the bone that covers the back of the spinal canal).

The ligamentum flavum (ligament of the spine) is then lifted up off the spinal cord.  Oftentimes, with age and arthritis, the ligament becomes excessively thick and hard, creating significant pressure and stress on the spinal nerves.  

The surgeon then decompresses one or both sides if needed to ensure that any bone or material causing compression is removed up off the spinal cord and nerve roots.  

How Laminotomy Works

Laminotomy surgery works by removing the overgrown bone or ligament (ligamentum flavaum) that is causing compression.

Laminotomy surgery helps by increasing the space surrounding your spinal cord and ensuring the spinal fluid that flows around your spinal cord has more room to flow normally.

By relieving the pressure, your nerves have more room and are in a better environment to heal as the inflammation settles down.  

Having laminotomy surgery typically translates to significant relief of symptoms such as pain and weakness.

Benefits of Laminotomy

Laminotomy can be done via minimally invasive methods with small incisions and the aid of a microscope.

Because it involves less muscle disruption, recovery tends to be faster, with shorter hospital stays and quicker returns to work and normal function.

It allows your surgeon to directly remove any offending agents and directly visualize your nerve roots to ensure they are well decompressed.

Because it does not involve a fusion, there is no compromise in flexibility or range of motion.

Recovering from Laminotomy

Recovery and prognosis for laminotomy are excellent.

Greater than 95 percent of patients have laminotomy on an outpatient basis and return home the same day as surgery.

You may experience two to three days of low-grade pain at the site of the incision, which is treated with pain medicine.

After laminotomy, most patients quickly experience complete relief from back and leg symptoms.

Most people completely recover in about three to six weeks with physical therapy.

It is common to have infrequent tingling, numbness, or shooting pains after surgery, which typically improve with time and physical therapy as the nerve continues to heal.

Generally, patients are encouraged to walk as much as possible in the first month, but to avoid bending, twisting, or lifting greater than 15lbs.

You start physical therapy at around 4 weeks, and typically return to normal activity by 3-4 months.