Decompressing spinal cord by

Laminotomy

Laminotomy is a surgical procedure that helps in

decompressing the spinal cord and spinal nerves emerging
from vertebral column. The main aim of a laminotomy is
to remove any structure narrowing the spinal canal and
also to release the entrapped nerves. A small incision is
made in the lamina in this procedure. In laminectomy,
entire disc is removed. Thus without compromising with
the spinal stability, laminotomy procedure achieves
decompression of spinal cord.

Vertebral column consists of 33 small bones called

vertebra. Each vertebra has a basic structure comprising
of a body anteiorly (in front) and a vertebral arch
posteriorly (behind).
The vertebral arch consists of two transverse procedures
that project sideways, two pedicles (flat bone between
body and transverse process), lamina (flat arched bone
between the transverse process and the spinous process)
and the spinous process (backward projection). The
vertebral arch encloses the spinal canal which lodges the
spinal cord.

Any space occupying structure within the spinal canal like

herniated or bulging disc, thickened ligament, osteophytes
(bone spurs), facet joint thickening can compress the spinal
cord resulting in pain, numbness, tingling and weakness of
the hand or legs. In extreme cases loss of bowel and bladder
control is also observed. Laminotomy aims at making an
incision in the lamina, to remove a small part of it, creating
room for the spinal cord within the canal. This relieves the
compression and thus the symptoms disappear. Through the
hole in the lamina, the thickened ligament or disc fragment
which may be compressing the cord and nerves are also
removed.

Spinal Surgery India

Patients suffering from ankylosing spondylitis,
degenerative disc disease, herniated disc, sciatica, spinal
stenosis, spondylitis, spina osteoarthritis for a prolonged
duration are the ones who would be going for a spinal
laminotomy procedure. The patient should be suffering
from these conditions for a considerably long period of
time and without any substantial relief from medications,
rest or physical therapy.

Laminotomy for decompressing spinal cord in India

Laminotomy is essentially a minimally invasive
endoscopic surgery. The operation is carried out after
giving local anesthesia. Patient is made to lie down on
abdomen. An incision is made in the midline onthe back
over the involved segments as suggested by X-Ray and
patient symptoms.

A round tube is inserted into the incision. Gradually, a small

series of tubes are placed over the initial tube slowly
increasing in size to make an opening for access to the
spine. The final working tube will be about 18 millimeters
in diameter which the surgeon will use to insert the laser,
camera, suction, irrigation and other surgical instrument.
With this minimally invasive method, the muscles are
pushed aside instead of being cut or torn.

After the working tube is placed the surgeon will perform the
surgery. Patients undergoing laminotomy feel instant relief as
the surgeon releases the entrapper nerves. Symptoms of back
and leg pain are resolved by decompressing the spinal canal.
When the surgeon is finished with the procedure the tube is
slowly removed, allowing for muscles to naturally shift back
to normal positions.

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