Laminotomy and Laminoplasty for Ruptured Disc

A laminotomy may be performed to provide the surgeon access to the ruptured disc material, and can be carried out using minimally invasive spine surgery.  The laminotomy procedure leaves the majority of the back bone intact to stabilize the spine, unlike a laminectomy, and may be preferred in cases where only a single disc has ruptured or is bulging.  The incision in the lamina is often only a few millimeters across but still provides good access for the surgeon to remove the material directly compressing the spinal nerves.  In cases where a significant amount of degenerated disc material is present the surgeon may feel that a more invasive procedure is necessary to effectively remove this ruptured material and thoroughly decompress the spine.  The risk associated with a second procedure, required due to residual compressing material, is considerably greater than the increased degree of invasion in the first procedure.

Laminoplasty is a type of back surgery where the laminae is scored on one side and opened like a door, with metal plates attached in order to maintain this position.  The extra space allows the spinal canal to relax and relieves pressure on the spinal nerves and cord.  Laminoplasty has the advantage of creating a reasonable amount of space for decompression purposes whilst maintaining the structure of the spine and reducing the need for fusion due to instability.  The surgeon will remove the ruptured disc material prior to fixing the lamina into its new position, thereby relieving spinal nerve pressure.

Continued Reading: Artificial Disc for Ruptured Disc