What is a Laminotomy?

For spinal stenosis treatment, the laminotomy, like the laminectomy, is designed to decompress the spinal canal and nerves. In the laminectomy the lamina in removed completely from the vertebra. In the laminotomy, only a portion of the lamina is cut and extracted. This is beneficial because the natural support of the lamina is left in place, increasing post operative stability and recovery. At the same time, the removal of part of the lamina creates more space for the spinal canal and nerves, successfully decompressing.

The most advanced form of this surgery, Microendoscopic decompressive laminotomy (MEDL), uses specialized surgical tools to minimize the damage to adjacent tissues and bone structures while still accomplishing the same decompression as an open laminotomy. The surgeon uses a tool that allows them to see inside the patient on a viewing screen, instead of having to create a large enough opening to see the operative areas with their own eyes. This minimally invasive surgery technique makes for a much smaller incision, and less damage to surrounding muscle groups. Also, in a small study (due to the relative young age of the operation), it was found to significantly reduce blood loss, postoperative stay, and pain medication.

One attractive aspect of the laminotomy is that if the patient is healthy, it's possible to leave the hospital within twenty four hours, or in other words, it can be an outpatient surgical procedure.

Laminotomy Indications

Patients to undergo a laminotomy should meet all the selection criteria as a patient for a laminectomy.

MEDL can also treat patients with:

• Symptoms of radiculopathy from either foraminal stenosis or disc herniation.

Patient should NOT undergo MEDL if they have evidence of:

• Lumbar instability

• Spondyloptosis

• Severe Deformity

• Severe Spondylolisthesis

• Spondylolysis

• Infection

• Tumor

• Arachnoiditis

• Pseudomeningocele

• CSF fistula

• Cauda equina syndrome