The lesser degree of invasion required by a laminotomy or laminoplasty in contrast to a discectomy, or laminectomy, gives these procedures the advantage in terms of recovery time, complication rates, and long-term spinal stability. A laminectomy may be more effective in achieving significant spinal decompression but can cause the spine to become unstable and lead to abnormal curvature. The degree of risk is lessened by maintaining the majority of the lamina and removing only a small portion to allow decompression, or by creating the hinged ‘door’ as occurs in a laminoplasty.
The application of laminotomy and laminoplasty has increased following advances in surgical techniques allowing discectomy to occur during the procedure. The removal of herniated discs may be possible during these less traumatic surgeries, removing the necessity for a laminectomy, discectomy, and fusion. Decompression of the spine can be effected through laminotomy and laminoplasty, allowing the spinal nerves, blood vessels, and spinal cord to relax and begin to heal following impingement by calcified tissue, osteophytes, or disc fragments. In some cases the removal of the calcified ligamentum flavum is often effective in itself at decompressing the spine and patients may experience significant relief from neck and back pain, radiculopathy, numbness, and weakness.
Those with cervical spondylitic myelopathy undergoing a laminotomy had an 86% success rate for decompression in a comparison done by Inoue (1996). The same author found a 65.4% rate of successful decompression with patients who has ossification of the posterior longitudinal ligament OPLL). In such cases where OPLL is present at many vertebral levels, an anterior corpectomy with fusion may be more appropriate. (Chen, 2010), although laminotomy and laminoplasty remain preferable when a single level, or two, are involved.
Recovery Time from a Laminotomy
Recovery time is significantly reduced following a laminotomy or laminoplasty in comparison to a laminectomy (Benglis, 2008). The decompression rates vary enormously between individuals but generally occur in around 80% of patients after one month. Complications are always a possibility, with the, less invasive laser surgery providing a reduction in risk compared to the traditional open surgical method. Discussing the options for surgery prior to making a treatment decisions ensures that any misunderstandings about potential risks and benefits of surgery are addressed prior to any procedure being carried out.