A minimally invasive method of decompressing
the structures of the spinal canal
Laminotomy is a surgery performed to decompress the structures of the spinal canal. The procedure involves cutting out a window in the back wall of the spinal canal, known as the vertebral arch lamina. Historically, for several decades, the primary decompression procedure was laminectomy, a complete excision of the posterior part of the spine. The main problem with this procedure was the destabilisation of the spine, as well as extensive trauma to the paraspinal muscles. Laminotomy was developed as a minimally invasive alternative. Its main advantage is the reduced interference with the structure of the spine, as well as minimising damage to adjacent tissues.
Indications for laminotomy surgery:
- spinal stenosis (narrow spinal canal)
- symptoms of pressure on the nerve roots: sciatic, brachial and femoral pain, difficulty in walking, numbness, paresis
- the classic symptom is the so-called neurogenic claudication, i.e. numbness in the lower limbs preventing further walking after a certain distance, usually less than 100 m
- no improvement after 3-4 weeks of conservative treatment/rehabilitation
Course of surgery
A microscope is required to perform the procedure. The procedure is carried out under general anaesthesia with the patient positioned on their abdomen. The skin is incised at a length of about 3-5 cm. There are two ways to perform laminotomy: way one is to cut the spinous process of the spine in the midline in half and open it laterally. The second way is to incise the vertebral arch on the side and enter the spinal canal. In both cases, the hypertrophied yellow ligament is removed to perform a full decompression of the canal.
Main benefits for the patient
- Minimally invasive procedure
- No interference with the mechanical structure of the spine
- Ensuring complete decompression of the spinal canal
- Quick verticalization – already the same day
- Rapid recovery
The laminotomy procedure is safe for the patient, the risk of complications is low. If complications do occur, they are usually mild and transient.
Possible complications include:
- lack of improvement, persistence of complaints
- damage to the root, which may manifest as pain, numbness or muscle weakness in the limb
- occasionally cerebrospinal fluid leakage
- infection – specifically in patients with associated conditions such as diabetes
approx. 40-60 minutes per 1 level
Duration of hospitalisation:
The procedure is performed as a one-day surgery. The patient can go home the next day after the procedure
approx. 4-6 weeks
Recommended depending on the health patient’s condition.
Additional postoperative rehabilitation packages are available at the Vratislavia Medica hospital.