Spinal Decompression Procedure
Lumbar back surgery often involves a laminectomy, laminotomy, or laminoplasty which are all procedures aimed at decompressing the back and relieving pressure on the spinal nerves and spinal cord. If disc herniation or osteophyte growth is reducing space in the spinal canal then the excision of a portion of the thick bony structure (lamina) covering the back of the spine can effectively decompress the back. A laminotomy is where a small window is cut into the back bone for decompression, a laminectomy involves the removal of a large portion of the back bone and often requires spinal fusion afterwards, and a laminoplasty creates a hinged effect in the back bone in order to increase the space without compromising spinal stability. The degree of lumbar stenosis and the presence of narrowing at one or more levels will determine which of these procedures is the most appropriate.
On occasion a microlaminoforaminotomy may be performed, where the patient has the foramen widened through a window cut into the lamina on one side of the spine. This procedure can effectively relieve spinal nerve root compression and give the spinal cord space to relax at the vertebral level where decompression needs to occur. As a microlaminoforaminotomy is minimally invasive and does no remove substantial structural material from the spine the procedure does not require spinal fusion afterwards and runs little risk of incurring spinal slippage following the surgery. Patients often have the procedure in an outpatient clinic and have a shorter recovery than those undergoing an open traditional laminotomy or foraminotomy either singly or in combination. The joint procedure may aid a back surgeon in assessing the degree of decompression achieved and can help ensure that the material compressing the nerves and cord is completely removed.
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