HEMILAMINECTOMY

Laminectomy vs. Hemilaminectomy

“Hemilaminectomy means only half of the lamina is removed.  This is a slightly smaller surgery than a laminectomy.  Usually a laminectomy is for spinal stenosis vs. a hemilaminectomy for a disc herniation.”

Dr. Michael Ramsey

 WHAT IT IS A HEMILAMINECTOMY?

Vertebrae anatomyA laminectomy is a surgical procedure in which space is created by removing the back part of a vertebra that covers the spinal canal, known as the “lamina”. The addition of the prefix “hemi”, which means half, doesn’t change much.  In fact, the addition of “hemi” changes less as a hemilaminectomy removes less bone.  A Hemilaminectomy is the partial removal of the lamina to decompress the spinal canal.  This procedure may also be referred to as decompression surgery. The goal of a hemilaminectomy or decompression procedure is to enlarge the spinal canal and take pressure off the spinal cord or nerves.

TREATING STENOSIS AND DISC HERNIATION

Conservative approach

A hemilaminectomy may be needed if conservative treatments fail to relieve the patients pain.   Initially, treatments such as medication, physical therapy, and injections may be attempted to help relieve the pressure on the spinal canal.  In our practice conservative treatments for spinal stenosis can be overseen by a spine surgeon, a PM&R (Physical Medicine and Rehabilitation) doctor, or a Interventional Pain Management Anesthesiologist.   Anatomical Cause   The need for a laminectomy or a partial hemilaminectomy is typically due to bony overgrowths within the spinal canal. These overgrowths cause the spinal canal to narrow which can put pressure on the nerves. The narrowing of the spinal canal is called stenosis, the narrowing that puts pressure on the nerve roots is called foraminal stenosis. This narrowing can result in pain, weakness, or numbness that radiates down your arms or legs.   Surgical intervention Your provider may recommend a laminectomy if:

  • Conservative treatment, such as medication or physical therapy, fails to improve your symptoms
  • You have muscle weakness or numbness that makes standing or walking difficult
  • You experience loss of bowel or bladder control

HOW IS A HEMILAMINECTOMY PERFORMED?

A laminectomy or hemilaminectomy can be performed traditionally, or minimally invasively.

  • The surgeon makes an incision in your back over the affected vertebrae and moves the muscles away from your spine as needed. The size of the incision may vary; the procedure may be minimally invasive which would result in a smaller incision.
  • Small instruments are used to remove the appropriate lamina.
  • If laminectomy is being performed as part of surgical treatment for a herniated disk, the surgeon also removes the herniated portion of the disk and any pieces that have broken loose (discectomy).

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