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.”
WHAT IT IS A LAMINECTOMY?
A 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”. This procedure may also be referred to as decompression surgery. The goal of a laminectomy or decompression procedure is to enlarge the spinal canal and take pressure off of the spinal cord. The enlargement of the canal allows the spinal cord room to exist un-impinged, or without compression, leading to nerves transmitting properly if they are not permanently damaged.
WHAT CAUSES THE NEED FOR A LAMINECTOMY?
A laminectomy 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 for a cervical laminectomy
The need for a laminectomy or a partial hemilaminectomy is typically due to bony overgrowths within the spinal canal from disc degeneration, arthritis, or even Ankylosing Spondylitis (Bechterew’s disease). 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: Cervical Laminectomy and Fusion
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 Cervical LAMINECTOMY PERFORMED?
A cervical laminectomy 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).
- Hardware may be nessicary to fuse the remaining piece of vertebrae to the level below the surgical site to add stability.
RECOVERY FROM A CERVICAL LANIMECTOMY
After having a cervical laminectomy, the majority of the initial pain should be relieved upon waking up from sedation. As the area heals and inflammation resolves the results can, and often do, get better. A neck brace may be required initially, but without risk factors or complications you will most likely be released to go home the day of the surgery. There will be post-operative appointments throughout your recovery and your physician may clear you to drive within a week or two from surgery. Light work can often be resumed within the first month, and full duty can often be resumed in under three months. Your physician may also recommend physical therapy if appropriate to your case. Due to the nature of cervical spine in the proximity to the brain, if anything is bothering you during the healing process let your physician know immediately and make sure you are following wound care recommendations completely. Cessation of smoking should be continued throughout the healing process as carbon monoxide inhibits bone healing.