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It often happens that the lamina bones in the spinal column degenerate after long periods of wear and tear. This degeneration is not life threatening but often results in a compression of the nerve roots that are housed in the spinal canal located between lamina bones. The result of this compression is back pain which is quite excruciating and stays for a very long time.
The Real Problem
Degeneration of the spinal bones, enlargement of the Facet joints, and the bulging of the disks results in severe or mild Sciatica. Further, because this reduces the amount of space available to spinal nerves that carry sensation to legs, a person may also experience weakness or numbness in the leg.
What's the Solution?
Presence of the above mentioned symptoms simply does not mean that there is a need to perform spinal surgery. Medical spine specialists first attempt to suppress this problem with the help of pain-relieving medication, physical therapy and/or rest. However, if nothing seems to work and the pain goes on increasing, the only method of treatment available is spinal surgery.
Laminotomy- How is it performed?
A patient is given general anesthesia and laid on the operating table in a face-down position. The area to be cut open is then marked and sterilized using antiseptic solution. It is draped and then incisions are made to reveal the underlying network of nerves and muscles. These are pulled aside and held with the help of a device called the retractor.
A bone drill is used in order to saw off a part of the lamina from both sides. Originally, this process involved only removal of either the left or right half of the lamina. Today, it is now more commonly carried out as the removal of a portion of both sides of the lamina. The remaining portion is retained in order to preserve the stability of the vertebral column.
Once the sawing off is performed, the wound is cleaned, sterilized and sealed with the help of embedded stitches. The effect of the anesthesia is broken and the patient gets up within a few hours of being moved out of the operation theatre. Movement is possible in a day or so but full recovery may take some more time.
Laminoplasty- Is it performed alone?
The answer to this question is- rarely. The objective of Laminoplasty is to reduce the amount of pressure on the nerve roots. Doing so requires not only sawing off a part of the lamina but also some part of the facet joint as well. Technically, this forms a part of another type of spinal surgery called Facetectomy. Hence, both Laminoplasty and Facetectomy are performed simultaneously to increase the intervertebral disk space.
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