A microlaminoforaminotomy is likely to be conducted under local anaesthetic with a mild sedative administered to the patient beforehand. The operation may be performed with the patient in an upright, sitting, position, or with them lying face down on the operating table. The patient’s head is usually restrained in some fashion in order to prevent movement during the neck surgery. The surgeon will swab and sterilize the area of the neck directly over the vertebrae to be operated on and then will make a very small incision of about 18mm in the back of the neck.
Through this incision the surgeon will then pass a series of tubes which gradually increase in diameter. This gradual expansion pushes the muscles and ligaments aside in order for the surgeon to access the back of the spinal column without having to sever any structural tissue. The surgeon will then use a small cutting tool to excise a portion of the lamina which covers the spinal cord and the problematic disc. This creates a window of approximately 3mm across through which the surgeon begins to remove the fragments of disc and osteophytes in order to decompress the spine. All of the tools used in this procedure are passed through the tube retractors, including an endoscope to allow the surgeon visual access to the area.
Once the disc and bone spurs have been removed the surgeon will gradually pull back the retractors and allow the tissues and musculature to gently slip back into place. Dissolving sutures are usually used to close up the incision at the back of the neck and the patient is allowed to rest as the anaesthetic and sedative begin to wear off. The procedure usually takes around an hour, depending on the extent of material to be removed, and any complications that may arise during the procedure.
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