Decompressing spinal cord by Laminotomy

Decompressing spinal cord by Laminotomy

Laminotomy is a surgical procedure that helps in decompressing the spinal cord and spinal nerves emerging from vertebral column. The main aim of a laminotomy is to remove any structure narrowing the spinal canal and also to release the entrapped nerves. A small incision is made in the lamina in this procedure. In laminectomy, entire disc is removed. Thus without compromising with the spinal stability, laminotomy procedure achieves decompression of spinal cord.

Vertebral column consists of 33 small bones called vertebra. Each vertebra has a basic structure comprising of a body anteiorly (in front) and a vertebral arch posteriorly (behind).

The vertebral arch consists of two transverse procedures that project sideways, two pedicles (flat bone between body and transverse process), lamina (flat arched bone between the transverse process and the spinous process) and the spinous process (backward projection). The vertebral arch encloses the spinal canal which lodges the spinal cord.

Any space occupying structure within the spinal canal like herniated or bulging disc, thickened ligament, osteophytes (bone spurs), facet joint thickening can compress the spinal cord resulting in pain, numbness, tingling and weakness of the hand or legs. In extreme cases loss of bowel and bladder control is also observed. Laminotomy aims at making an incision in the lamina, to remove a small part of it, creating room for the spinal cord within the canal. This relieves the compression and thus the symptoms disappear. Through the hole in the lamina, the thickened ligament or disc fragment which may be compressing the cord and nerves are also removed.

Spinal Surgery India Patients suffering from ankylosing spondylitis, degenerative disc disease, herniated disc, sciatica, spinal stenosis, spondylitis, spina osteoarthritis for a prolonged duration are the ones who would be going for a spinal laminotomy procedure. The patient should be suffering from these conditions for a considerably long period of time and without any substantial relief from medications, rest or physical therapy.

Laminotomy for decompressing spinal cord in India Laminotomy is essentially a minimally invasive endoscopic surgery. The operation is carried out after giving local anesthesia. Patient is made to lie down on abdomen. An incision is made in the midline onthe back over the involved segments as suggested by X-Ray and patient symptoms.

A round tube is inserted into the incision. Gradually, a small series of tubes are placed over the initial tube slowly increasing in size to make an opening for access to the spine. The final working tube will be about 18 millimeters in diameter which the surgeon will use to insert the laser, camera, suction, irrigation and other surgical instrument. With this minimally invasive method, the muscles are pushed aside instead of being cut or torn.

After the working tube is placed the surgeon will perform the surgery. Patients undergoing laminotomy feel instant relief as the surgeon releases the entrapper nerves. Symptoms of back and leg pain are resolved by decompressing the spinal canal.

When the surgeon is finished with the procedure the tube is slowly removed, allowing for muscles to naturally shift back to normal positions.

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