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A hemilaminectomy, sometimes referred to as laminotomy, is a minimally-invasive surgical procedure that aims to enlarge the space in the spinal canal to reduce nerve compression or pressure. This is done by removing part of a vertebra, called a lamina, that has been damaged or is damaging surrounding structures. Each vertebra contains two laminae, which are bony segments that form the rear of the vertebral arch and serve as a base for the vertebrae, covering and protecting the spinal column. A hemilaminectomy can be done to address nerve compression in all three regions of the spine – lumbar, thoracic, and cervical.
A hemilaminectomy is a less invasive alternative to a full laminectomy – half as much bone is removed from the spine, and most of the bone is preserved. This is a decompressive procedure, meaning it is used to alleviate spinal compression. Removing all or part of the lamina during either a hemilaminectomy or a laminectomy allows a compressed nerve more space and a better environment to heal and grow. Because only a small portion of the lamina, and only on one side, the integrity of the spine is preserved and postoperative spinal instability is decreased.
During the procedure, a small incision is made along the midline of the back. Special retractors are used on the soft tissues and muscles to get a clear view of the spinal canal without cutting any of the structures open. An endoscope is inserted to allow the surgeon visualization of the area. Through this window, part of the lamina is removed, along with any other sources of compression, such as bone spurs or damaged disc material, to relieve additional symptoms. Once these materials have been removed from the affected area, the tissue and muscles are put back in place and the incision is stitched together.
Though less invasive than a laminectomy, hemilaminectomy surgery is often an inpatient procedure. Typically, a hemilaminectomy takes around 70-85 minutes, and patients are usually required to stay overnight and are discharged the next day following the procedure. And much like any surgery, there is a chance of complications. Your surgeon will be happy to fully discuss the risks and benefits of a hemilaminectomy.
Any sutures from your hemilaminectomy will be removed after 10 days, and you should be able to return to your normal routine after four to six weeks. Physical therapy and/or other post-surgical rehabilitation can start after six weeks, depending on your recovery.
According to studies, hemilaminectomy has an advantage over other forms of spine surgery in that they minimize injury to muscles, ligaments, and bones in and around the spine. This often helps recovery.
The spine surgeons at Interventional Spine & Surgery Group utilize minimally invasive techniques during surgery to make recovery as quick and with as little pain as possible.
A hemilaminectomy may be done in conjunction with another procedure, in order to address a spine condition that is causing additional symptoms. For example, if you have severe disc damage, your surgeon may recommend hemilaminectomy discectomy surgery. Your surgeon will first remove part of the lamina(the hemilaminectomy), then access and remove the damaged disc. This is the discectomy part of the procedure. How long (if at all) your hospital stay might be dependent on how extensive your surgery was and what combination of procedures was involved.
You may be a candidate for a hemilaminectomy if you suffer from a condition involving a pinched nerve. These spinal conditions may include:
If the source of your pain is nerve compression, you may experience symptoms such as:
If you are suffering from neck or back pain associated with a pinched nerve, and have exhausted conservative treatment options like physical therapy, injections, or massage, your doctor may suggest a hemilaminectomy.
Non-surgical treatment can address some of the pain and associated symptoms, but for a more serious case, the answer may be to surgically remove the bone and other material that is putting pressure on the nerves and causing your pain.
Not all patients with nerve compression are candidates for hemilaminectomy; patients with extensive compression may be better suited for a full laminectomy or another spine procedure, like a spinal fusion.
The surgical team at Interventional Spine & Surgery Group is equipped to perform a hemilaminectomy, along with various spine procedures, using minimally invasive techniques in order to optimize your recovery. Minimally invasive surgical techniques result in quicker recovery periods, smaller incisions and less scarring, lower risk of infection and complications, and less disruption of muscles, nerves, and other soft tissue.
Call us today to discuss whether a hemilaminectomy may be a good option to relieve your back pain.