Foraminotomy vs laminectomy


Topic Tags: Laminectomy vs. Laminotomy and laminectomy are two different types of spinal decompression surgeries that involve accessing the lamina of the spine. The lamina is a bony plate that covers the back of the spinal canal. The difference between these two different procedures is glaring. A laminectomy refers to an operation that totally removes the lamina. On the other hand, a laminotomy is simply the partial removal of the bone. Depending on the nature of your case, your spine surgeon may choose one or the other to gain access to the affected area that is causing neck or back pain, as well as any other neurological symptoms.

Laminectomy, Laminotomy, Foraminotomy, Laminoforaminotomy

Your doctor will have their reasons for performing one of these procedures over the other. The main goal regardless of the specifics of your case will be to create space around the spinal cord and surrounding nerves by removing structures that cause compression. In some cases, these procedures may be performed because the lamina itself is the structure compressing your nerves.

In other instances, your surgeon may need to remove parts of the lamina to gain access to other parts of the spine. A common example involves removing the lamina so that the surgeon may have a better view of a herniated or bulging disc.

When the spinal cord or a nerve therein becomes compressed, you may experience neurological symptoms such as numbness, weakness, and pins and needles sensations.

Therefore, the goal is to decompress the affected neural structures in order to eliminate the unpleasant, associated symptoms. Both surgeries are performed using a posterior approach, meaning that you will be lying face down for the duration of the operation. The surgeon will start by making an entry point incision near the affected area. Once the incision is made, the surgeon will then use a retractor to move the skin, fat, and muscles to the side.

Doing so will allow your surgeon to avoid unnecessary damage to these structures during the procedure. Next, your surgeon will then perform the appropriate procedure. He or she will make sure to the handle the damaged nerves that radiate from the spinal cord with care.

Additionally—after removing part or all of the lamina—your surgeon will then remove all or part of the affected discs or bone spurs that cause the pinched nerve. At this point, your surgeon will now choose to do any number of other procedures, such as a foraminotomy or spinal fusion before closing the initial entry incision. Generally speaking, surgeons do not perform laminotomies and laminectomies at the same time.

That being said, your surgeon may perform both if your condition affects multiple levels of the spine. Surgeons have historically performed these two procedures in a traditional open way.

However, in recent times it is has become possible to approach these operations with a minimally invasive approach. Additionally, this also means less scarring and a speedy recovery. Your doctor will be able to perform these procedures on an outpatient basis, usually in an ambulatory surgery center. Outpatient surgery provides the patient with much more comfort and convenience than traditional open surgeries.

foraminotomy vs laminectomy

From beginning to end, an outpatient surgery generally takes around 45 minutes to complete. The downside of these two minimally invasive options is that they are simply not a viable choice for everyone. Some patients have spinal problems that a surgeon cannot address by anything but traditional surgery.A foraminotomy is a surgical procedure designed to lower pressure within the spinal canal by enlarging the passageway through which a spinal nerve root branches from the spinal canal.

A laminectomy is a procedure to remove a greater portion of the bone lamina covering the roof of the spinal canal. A discectomy is a procedure to remove a portion of a herniated disc in the spine, which is bulging and pushing on a nerve.

Understanding spine anatomy is important to understanding the difference between the different procedures to relieve pain. The sensitive spinal nerve roots are responsible for transmitting signals for voluntary muscle control as well as relaying sensory information for most of the rest of the body.

The spinal discs shock-absorbing pads between our vertebrae give the spinal nerve roots enough room to exit the spinal canal.

Sometimes, however, impact trauma, daily stress on the spinal discs, bone growths, or tumors may create an obstruction for the spinal nerve roots. A foraminotomy focuses more on removing a smaller portion of bone where the nerve root leaves the spinal canal.

The opening in the spine through which the nerve root leaves is known as the neural foramen, and opening of this area is thus known as a foraminotomy. A laminectomy is a more extensive removal of a greater portion of bone covering the spinal canal. Of note, the neural foramen is an opening created by a roof of the superior articular facet of the vertebral body below, and the inferior articular facet of the vertebral body above. A discectomy is performed by making an opening in the lamina, in order for the spine surgeon to gain access to the disc space, where the herniated or bulging disc is situated, in order to perform a discectomy, free up the nerve root, and alleviate the pain resulting from nerve compression.

There are several different spinal conditions that may prompt a physician to consider a foraminotomy. Degenerative disc diseasea condition in which the natural degeneration of spinal discs is accelerated by other factors, is a possible cause. When there is a more diffuse narrowing of the spinal canal, as is the case with spinal stenosis, a foraminotomy may not be sufficient to decompress the nerves, and a laminectomy may be required. When the source of compression is located centrall within the spinal canal, and is caused by a focal disc bulge or herniation, rather than a diffuse central canal compression, then a discectomy may be a good option.

Since back surgery is often a costly procedure with a lengthy period of post-operative care, patients are advised to seek thorough medical consultation prior to any procedure that may have implications for the spinal canal.

If patients are experiencing muscle weakness, sharp or shooting pains down one or both legs, numbness in the extremities, or if their low back pain is not resolved by core strengthening exercises and weight management, physicians will typically recommend a series of spinal imaging tests. X-rays, magnetic resonance imaging, and CT scans may all be used to determine whether the integrity of the spinal canal is at risk.

Post-imaging, physicians will be much better equipped to make an accurate diagnosis and prescribe a course of treatment. Post-operative care will normally include physical therapy that focuses on core strengthening exercisebuilding the muscles in the torso to assist in managing the stresses of everyday movement. Physician experts at the Kraus Back and Neck Institute KBNI in Houston TX have significant experience at taking care of patients with back problems, back injuries and other sources of back and neck pain, arm and leg pain.

They frequently see patients who are suffering from the symptom of neck pain, low back pain, and mid back pain, and have never received imaging studies of the spine. The physicians have expertise on spine surgery including foraminotomy and laminectomy and discectomy. Physicians at the KBNI will order the appropriate spinal imaging studies of the cervical, thoracic or lumbar spine as needed, and review the results with the patient.

Patients suffering from neck pain or back pain, or who have been told they may require a spine surgery, can contact the Kraus Back and Neck Institute at. Or visit www. This entry was posted on July 15,am and is filed under baytownbeaumontcervical laminectomycervical stenosisdiscectomyforaminotomyherniated discherniated disc surgeryhoustonkatylaminectomylumbar laminectomyspinal stenosiswoodlands.Bulging or collapsed disks, thickened joints, loosened ligaments, and bony growths can narrow the spinal canal and the spinal nerve openings foramencausing irritation.

Symptoms of spinal nerve compression include:. Laminotomy or laminectomy. These procedures involve removing a small part of the bony arches of the spinal canal, called the lamina.

During a laminotomy, just a section of the lamina is removed. During a laminectomy, the entire lamina is removed. Removing the lamina increases the size of the spinal canal, relieving pressure. Both procedures are performed to expand the openings for the nerve roots to exit the spinal cord by removing some bone and other tissue. A foraminectomy generally refers to a procedure that removes a large amount of bone and tissue. A combination of techniques may be used; and in some cases, fusion of the vertebrae also is needed to stabilize the spine.

You will stay in the hospital for 4 or 5 days, depending on the extent of your surgery. You will be given medication to control pain. Rehabilitation may be lengthy and will likely include a program of physical therapy.

Surgery does not correct the underlying degeneration of the vertebrae due to wear and tear of aging, however, so a return of symptoms is possible.

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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. You have several options, including a corpectomy, a diskectomy, a laminotomy, a foraminotomy, or osteophyte removal.

Appointments Why are spinal decompression surgeries done?The spinal column consists of vertebrae separated by discs. Each vertebra consists of a main body vertebral body in the front and a bony canal spinal canal in the back. Between each of the bodies is a disc. The bony canal in the back contains the spinal cord and nerves. The roof of this canal is called the lamina. The spinous process is a bone between the laminae. This is the bone you feel when you press on your spine. The nerves exit the spinal canal through a small window called the foramina.

A laminectomy is a procedure when the whole lamina is removed. This is typically performed in an open i. This procedure leaves the spinal canal open, and can be quite traumatic because the muscles, tendons, and ligaments that are normally attached to the spine must be stripped off and the entire lamina and spinous process are typically removed.

The surgeons at Orthopedics International rarely have to perform open laminectomies, and believe it will be an outdated procedure in the near future.

foraminotomy vs laminectomy

A minimally invasive laminotomy, on the other hand, is a procedure that involves removal of a much smaller area of the lamina on one or both sides creating small holes that decompress the spinal cord and nerves.

Unlike the laminectomy, a laminotomy can be performed in a minimally invasive fashion. Although the amount of bone that is removed is much less compared to an open laminectomy the surgical goals can still be achieved. Outcomes of a laminotomy from a functional and anatomic perspective are equivalent to the larger more open procedure of a laminectomy. The laminotomy is the procedure of choice for the minimally invasive spine surgeons at Orthopedics International.

A minimally invasive foraminotomy is a procedure that opens up the foramina small window where the nerves exit the spinal canal. When they become narrowed stenoticthis procedure takes the pressure off of the exiting nerve root. Disc bulges can also contribute to this narrowing. Often discrete bone spurs will form pinching a nerve. A person can also be born with a small spinal canal; this is called congenital spinal stenosis. Less common conditions that can lead to stenosis and require a decompression include facet cysts, fractures, and tumors.

It is unclear why some people develop spinal stenosis and others do not. As previously mentioned, soft tissue and bony structures can narrow the areas where the neural elements live in the spinal canal. When the narrowing occurs in the spinal canal, we call this central stenosis. When narrowing occurs in the foramina, we call this foraminal stenosis. Spinal stenosis is a common problem in people over 50 years old. It most commonly occurs in the mid to lower lumbar spine and women are typically affected more often than men.

The leg symptoms are quite varied, ranging from mild aching to severe fatigue. Leg pain, buttock pain, pins-and-needles sensations, and numbness are also common symptoms in patients with spinal stenosis.

Your ability to walk may also be limited to a few blocks. The goal of laminotomies and foraminotomies is to open up the areas for your nerves by removing the excess bone and soft tissue.

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A one-inch incision is made in your back at the operative level.Laminectomy, laminotomy, foraminotomy, and laminoforaminotomy are related procedures in which a surgeon removes bone from the spine.

This page will give a general overview of these procedures. For more in-depth information, see our pages on cervical and thoracic laminectomy and lumbar laminectomy.

Spinal Surgeries: Laminotomy versus Laminectomy

In most cases, these procedures will not significantly affect the strength of the spine. The bone removed from the lamina or foramina does not necessarily need to be replaced with anything. This procedure uses bone graft and metal implants to restore spinal strength and stability. Paul C. McCormickMichael G. KaiserPeter D. AngevineAlfred T. OgdenChristopher E. MandigoPatrick C. Search for:.

Discectomy vs Laminotomy by Dr. Tony Mork

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Neil A. Laminectomy, Laminotomy, Foraminotomy, Laminoforaminotomy. Overview Laminectomy, laminotomy, foraminotomy, and laminoforaminotomy are related procedures in which a surgeon removes bone from the spine. The extent of bone removal depends on the situation: in some cases, only part of one side of one lamina is removed.

In a more extensive removal, the surgeon may remove both sides of several laminae.Photo Source: Shutterstock. There are two types: A laminectomy or laminotomy.

In laminectomy, the lamina is removed in nearly its entirely. The large, powerful muscles of the back provide quite adequate protection for the nerves below. So your spinal nerves will remain safe and secure following laminectomy. Which one is right for you?

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It depends on your situation. Laminotomy is used almost exclusively to enter the spinal canal to remove a herniated disc. Laminectomy and laminectomy are on a spectrum, with a laminectomy removing more bone and sometimes the inner edge of the facet joint. Most people with spinal stenosis —a narrowing of the spinal canal, usually caused by arthritis and overgrowth of the spinal discs and joints—or similar compression issues respond well to non-surgical treatment.

But surgery may be necessary to treat certain uncommon but potentially severe situations. These kinds of situations include patients with:. The primary goal of decompression surgery is to create space around the spinal cord and surrounding spinal nerves by removing the compressing structure s.

Lumbar laminectomy is the most common surgical procedure to treat spinal stenosis in the lower back. It can also help treat herniated discs by allowing the surgeon to more easily access the disks in order to repair the damage. The surgery removes the lamina and any thickened ligaments that are also causing problems in order to create more space in the spinal canal.

By removing the source of the pressure, pain decreases, particularly pain caused by compressed nerves. Some of the other techniques that [surgeons] have for doing minimally based approaches are operating through a tube. They've adapted those techniques for being able to decompress this just by going on, say, the right side of the spine, and still being able to decompress then both the right and the left side. Both the minimally invasive and traditional open laminectomy procedures accomplish the same goals.

foraminotomy vs laminectomy

The difference is the minimally invasive version involves one or more tiny incisions or skin punctures and small instruments designed to separate muscles and soft tissues instead of cutting through them. The traditional open approach requires a larger skin incision and instruments that retract, separate and cut tissues.

foraminotomy vs laminectomy

Surgeon preparing to begin spine surgery by making the first incision. Photo Source: RF. It can either be an open procedure or as a minimally invasive procedure sometimes called a microlaminectomy. In an open laminectomythe surgeon begins by making an incision near the affected spinal level.

Once the incision has been made, a retractor will move your skin, fat, and muscles to the side so your surgeon can access your spine. Once that is completed, the retractor is removed and the incision is closed with sutures. Microlaminectomy, a type of minimally invasive spine surgery or MIS, is performed using special instruments such as endoscopes and tubular retractors. These instruments allow for much smaller incisions and less cutting overall.

In this case, once the incision is made, the surgeon uses tubular retractors to hold the tissue apart. He or she will also be using special eyewear loupes in order to have a detailed view of the surgical field. Sometimes, instead of loupes, the surgeon uses either an endoscope or a microscope focused down the tube in order to perform the surgery.Therefore tips 12 free 100. Hence free fixed matches today. Weekly Football Betting Cash back Specials and Enhanced Odds betting offers.

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