A laminotomy is a surgical procedure to remove a piece of the back part of a vertebra (lamina). This surgery relieves pain caused by compressed nerves in your spine. Most people go home the same day as surgery and report significant pain relief.

A laminotomy is surgery to remove a piece of your lamina. The lamina is the back part of a vertebra (bone) in your spine. The lamina protects and supports the back of your spinal cord.

Unlike a laminectomy, which removes the entire lamina, a surgeon will drill a hole into the lamina and only remove a small piece of it for a laminotomy. This relieves pressure on compressed nerves.

Many people choose a laminotomy if they experience nerve pain that doesn’t go away with other forms of treatment. It’s minimally invasive.

A laminotomy treats compressed nerves. You might have irritated or compressed nerves if you have conditions like:

  • Arthritis.
  • Bone spurs.
  • Herniated disk.
  • Spinal stenosis.
  • Tumors.

Your healthcare provider might recommend this surgery if your condition causes symptoms like:

  1. Persistent back or neck pain.
  2. Numbness or tingling in your arms and legs.

These symptoms can affect your ability to move and enjoy everyday activities.

A laminotomy is one of the most common procedures to treat spinal stenosis.

 

You’ll meet with your surgeon before your laminotomy. You can expect your surgeon to complete the following at that appointment:

  • A physical exam.
  • Imaging tests like an X-ray, myelogram or MRI.
  • A complete medical history.
  • Ask you about what medications or supplements you currently take.
  • Make changes to your medications like removing or adding certain medications. Don’t stop taking medications unless your healthcare provider approves it.

Let your healthcare provider know if you use tobacco products. Nicotine within tobacco products can interfere with healing, so your provider may ask that you quit before the procedure.

Your surgeon will also explain any risks or side effects and give you information about how you can prepare. If you have any questions or concerns, make sure you ask your surgeon before the date of your surgery.

At the hospital, an anesthesiologist will give you anesthesia. Depending on what your surgeon decides is best for your situation, you may receive a local anesthetic where you’re awake but won’t feel any pain.

During the surgery, you’ll lie on special pads, face down, so your surgeon can complete the procedure on your backside. Your surgeon will:

  • Make an incision (cut) in your skin near the affected lamina on your spine.
  • Drill a hole into the affected lamina bone. This hole or window is only a few millimeters wide.
  • Close the incision site.

A laminotomy usually takes about an hour to an hour and a half to complete if your surgeon is only working on one vertebra.

After a laminotomy, your care team will observe you until your anesthetic wears off. You’ll likely receive medications to manage pain or discomfort.

A minimally invasive laminotomy is an outpatient procedure. This means you’ll be able to go home on the same day as your surgery. You’ll need to ask someone to drive you home from the hospital.

You’ll also get instructions from your surgeon on how to take care of yourself after your surgery. These will explain:

  • How to care for the incision site.
  • What activities are safe to do.
  • What side effects to look out for.
  • What exercises are safe to do.

You may find it uncomfortable to stay in one position for a long time, especially sitting or standing. Your surgeon might recommend physical therapy to improve and strengthen your muscles and range of motion.

If you have any questions, contact your healthcare provider.

A laminotomy can help reduce or eliminate pain and symptoms caused by a compressed nerve. It’s also a minimally invasive procedure that can significantly reduce your surgery and healing time.

The success rate of a laminotomy procedure is 60% to 80% according to one study. This calculates the effectiveness of the surgery to relieve pain and level of disability.

Risks or complications are rare for a laminotomy but may include:

  • Infection.
  • Bleeding.
  • Nerve damage.
  • Blood clots.
  • No change to pain or relief of symptoms.
  • Bladder and bowel management issues.

It usually takes six weeks to completely heal after a laminotomy. Each person heals differently, so your recovery time may be longer or shorter than average. Follow your healthcare provider’s instructions to take care of yourself after surgery and improve your recovery time.

After your surgery, you’ll feel sore. Your surgeon will recommend taking pain medications for a few days following the procedure. Let them know if you experience severe pain or worsening pain. The pain you originally felt before the procedure should immediately go away or reduce after your surgery.

 

When should I call my healthcare provider?

Contact your healthcare provider if you notice complications or signs of an infection like:

  • Severe pain or worsening pain.
  • Swelling.
  • Skin discoloration.
  • Fever.
  • Difficulty breathing.
  • Difficulty peeing or pooping.
  • Persistent drainage from the surgical wound.
  • American Academy of Orthopaedic Surgeons. Minimally Invasive Spine Surgery (https://orthoinfo.aaos.org/en/treatment/minimally-invasive-spine-surgery). Last reviewed 6/2022. Accessed 12/14/2023.
  • American Academy of Orthopaedic Surgeons. Preparing for Low Back Surgery (https://orthoinfo.aaos.org/en/treatment/preparing-for-low-back-surgery/). Last reviewed 4/2022. Accessed 12/14/2023.
  • Haddadi K, Ganjeh Qazvini HR. Outcome after Surgery of Lumbar Spinal Stenosis: A Randomized Comparison of Bilateral Laminotomy, Trumpet Laminectomy, and Conventional Laminectomy (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4824790/)Front Surg. 2016;3:19. Accessed 12/14/2023.
  • National Health Services (U.K.). Lumbar Decompression Surgery (https://www.nhs.uk/conditions/lumbar-decompression-surgery/). Last reviewed 4/28/2022. Accessed 12/14/2023.
  • National Library of Medicine (U.S.). Laminectomy (https://medlineplus.gov/ency/article/007389.htm). Last reviewed 12/12/2022. Accessed 12/14/2023.
  • Polikandriotis JA, Hudak EM, Perry MW. Minimally Invasive Surgery Through Endoscopic Laminotomy and Foraminotomy for the Treatment of Lumbar Spinal Stenosis (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3768246/)J Orthop. 2013;10(1):13-16. Accessed 12/14/2023.
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