Laminectomy is a back surgical procedure commonly performed on the cervical, thoracic or lumbar sections of the spine depending on the condition. Cervical, thoracic and lumbar laminectomy and foraminotomy procedures are often performed on those diagnosed with spinal stenosis. Also known as decompression, the surgical procedures remove a small portion of the vertebra called the lamina or the foramen. The lamina is found on the back or dorsal portion of the vertebra, the area that covers the spinal canal. The foramen is the space that allows the spinal cord nerves to branch off the cord into other areas of the body.
A foraminotomy is a surgical procedure that widens the opening in the back or area of the spinal canal that allows passage of spinal nerve roots from the spinal cord to other parts of the body.
Removing a portion of the lamina and foramen helps relieve pressure or compression against spinal cord, nerves, and surrounding tissues caused by a narrowing of the spine structure. Laminectomy and foraminotomy procedures are often performed in the treatment of herniated or bulging vertebral discs spaces.
Individuals who experienced pain, limited movement and mobility or tingling or numbness caused by pressure against spinal nerves or the spinal cord may benefit from laminectomy or foraminotomy procedures. Such procedures are often recommended to those who haven't received relief or improvement of their condition through medications, or physical therapy. Those who experience difficulty walking or mobility caused by muscle weakness, muscle spasms or numbness as well as those who experience loss of bladder or bowel control may also benefit from the procedure.
For an open laminectomy and foraminotomy procedure, the patient is placed under general anesthesia. The surgeon makes an incision in the back over the area of the spine more the spinal compression is located.
The surgeon uses small instruments to scrape away or remove portions of the lamina in the disc or discs causing the problem. He then shaves or cuts away small portions of the foramen, or the space where nerve roots branch off from the spinal cord in the cervical, thoracic or lumbar area to make more room for these nerves. The surgeon may need to use a surgical microscope to see this area more clearly.
At this time, the surgeon will also determine the overall health and condition of the vertebra and vertebral discs adjacent to the problem area. In some cases, other procedures made at this time, such as removal of a herniated or bulging disc, called a discectomy, or spinal fusion if vertebra has slipped out of position.
For a laparoscopic laminectomy or foraminotomy, a small incision is made over the affected spine area. A very small camera attached to the end of a long tube is inserted into the incision, which allows the surgeon to view the operating field on a video monitor in the surgical suite. Very small surgical instruments are inserted into one or more small incisions around the affected disc area and the operation proceeds in much the same way and open laminectomy procedure is performed.
However, if the surgeon feels you may have a herniated or bulging disc or any spine instability, the patient may not be considered a good candidate for this approach. Following the procedure, the surgeon will use stitches or staples to close the incision area.
In most cases, you will stay in the hospital for 1 to 3 days, depending on your overall health and wellness, your physical condition and your response to the surgery. A physical therapist may be offered to help you ambulate and perform daily functions, depending on the area where the laminectomy occurred.
A laminectomy or foraminotomy procedure is generally performed by an orthopedic surgeon specializing in spine care or neurosurgeon as well as a vascular or general surgeon trained in laparoscopic procedures. Surgeons should be chosen according to their expertise and experience in related fields. Physicians and surgeons should be certified in their field, and show membership in national or regional boards or associations in his or her country of origin. Consumers are encouraged to get more than one opinion before engaging in any type of spinal surgery, as well as making sure that facilities, surgeons, and healthcare staff are accredited by international associations and organizations to ensure quality of equipment, technology, as well as quality of care by medical staff.
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