Laminotomy is a surgical procedure that decompresses the spinal cord by removing structures narrowing the spinal canal, thus alleviating symptoms like pain and weakness. It is a minimally invasive operation performed under local anesthesia, involving a small incision and the use of specialized tubes for access to the spine. Patients suffering from chronic conditions such as herniated discs or spinal stenosis typically undergo this procedure for relief after conservative treatments fail.

1. Decompressing spinal cord by
Laminotomy

2. 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.

3. 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.

4. 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.

5. 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.

6. 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.

7. 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.

8. 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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