Type of Surgery
Last updated: 02/17/2009
A laminectomy is performed with the patient under general anesthesia, usually positioned lying on the side or stomach. The surgeon begins by making a small straight incision over the damaged vertebra.
The surgeon next uses a retractor to spread...
apart the muscles and fatty tissue overlying the spine. When the laminae have been reached, the surgeon cuts away part of the bony arch in order to expose the ligamentum flavum, which is a band of yellow tissue attached to the vertebra that helps to support the spinal column and closes in the spaces between the vertebral arches. The surgeon then cuts an opening in the ligamentum flavum in order to reach the spinal canal and expose the compressed nerve. At this point the cause of the compression (herniated disk, tumor, bone spur, or a fragment of the disk that has separated from the remainder) will be visible.
Bone spurs, if any, are removed in order to enlarge the foramina and the spinal canal. If the disk is herniated, the surgeon uses the retractor to move the compressed nerve aside and removes as much of the disk as necessary to relieve pressure on the nerve. The space that was occupied by the disk will be filled eventually by new connective tissue.
If necessary, a spinal fusion is performed to stabilize the patient's lower back. A small piece of bone taken from the hip is grafted onto the spine and attached with metal screws or plates to support the lumbar vertebrae.
Following completion of the spinal fusion, the surgeon closes the incision in layers, using different types of sutures for the muscles, connective tissues, and skin. The entire procedure takes one to three hours.
Laminectomy is a spine operation to remove the portion of the vertebral bone called the lamina. There are many variations of laminectomy, in the most minimal form small skin incisions are made, back muscles are pushed aside rather than cut, and the parts of the vertebra adjacent to the lamina are left intact. The traditional form of laminectomy (conventional laminectomy) excises much more than just the lamina, the entire posterior backbone is removed, along with overlying ligaments and muscles. The usual recovery period is very different depending on which type of laminectomy has been performed: days in the minimal procedure, and weeks to months with conventional open surgery.
Select comparative data from 1999 to 2006 include a decrease of 14 percent in the number of neurosurgeons in private practice and a decrease of 13 percent in the number of neurosurgeons in solo practice.
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