Spinal Decompression Surgery - Laminectomy, Laminotomy, Foraminotomy, Laminoplasty

Mercy Medical Center, in Baltimore, Maryland, offers comprehensive care for a wide range of spine conditions, including physician expertise provided by orthopedic surgeons and neurosurgeons.

The experienced spine surgeons at Mercy use advanced minimally invasive techniques to provide various types of spinal decompression surgeries including laminectomy, laminotomy, foraminotomy and laminoplasty. These procedures are performed to relieve symptoms of spinal nerve compression.

What is Spinal Decompression Surgery?

Spinal decompression surgery is used to address the narrowing of the spinal canal which may create pressure on the spinal cord or spinal nerves. Spinal nerve compression may be associated with:

• Disc degeneration
• Disc herniation
• Radiculopathy and myelopathy
• Spinal stenosis
• Bony overgrowths from arthritis

The pressure on the spinal nerves (sometimes referred to as a "pinched nerve") may cause intense pain or numbness, weakness and tingling in certain areas of the body.

Typically more conservative treatments, including injections, medications and physical therapy, are employed first. If these treatments are ineffective your doctor may recommend spinal decompression surgery.

There a various types of spinal decompression surgery including laminectomy, laminotomy, foraminotomy and laminoplasty.

What types of Spinal Decompression Surgery are available?

Spinal decompression surgery encompasses several types of surgery aimed at relieving symptoms caused by spinal nerve compression by widening the spinal canal. These surgeries can be performed in different areas of the spine, most commonly the cervical spine (neck area) and lumbar spine (lower back area).

Most spinal decompression surgeries involve the lamina, the "roof" section of the bony vertebral arch, which encloses the spinal cord. The spinal column includes 33 vertebrae, stacked upon each other. Spinal decompression surgery is not performed on the entire spine, but rather a small area of the spine where the compression is occurring.

Mercy's spine doctors use minimally invasive techniques to perform spine surgery. Minimally invasive surgery allows for a smaller incision, typically resulting in less pain and a faster return to daily activities. Mercy's doctors provide the following spinal decompression surgeries:

• Laminectomy - removal of the lamina in the affected area of spine
• Laminotomy - removal of a small section of the lamina in the affected area of the spine
• Foraminotomy - removal of bone around the neural foramen in the affected area of the spine
• Laminoplasty - cutting the lamina and swinging it open like a door to create more space (performed only in the cervical spine)

What is Laminectomy?

A laminectomy is a spinal decompression surgery performed to create more space in the spinal canal by removing the lamina in the area where the spinal compression is occurring. Laminectomy may be performed in conjunction with spinal fusion.

During a laminectomy a small incision will be made in your back or neck over the affected vertebrae. Tiny instruments will be inserted through the incision to cut and remove the lamina. If the laminectomy is being performed in conjunction with a spinal fusion, two or more vertebrae will be permanently joined together.

What is Laminotomy?

A laminotomy involves the removal of only a small section of the lamina with the goal of creating more space in the spinal canal to relieve the compressed nerve. By removing only a portion of the lamina, the natural structure remains in place, promoting better spinal stability following surgery.

Mercy's surgeons use minimally invasive techniques including an endoscope (small camera) which is inserted through a tiny incision in the back or neck to perform the surgery. The surgeon will cut and remove a small piece of the lamina through the small incision and then close the incision.

What is Foraminotomy?

A foraminotomy may be performed in conjunction with a laminectomy or laminotomy. It involves the removal of bone around the neural foramen, the space in between the vertebrae where the nerve root exits the spinal canal.

What is Laminoplasty?

Laminoplasty, also called cervical laminoplasty, is performed only in the neck area of the spine. Through a tiny incision in the back of the neck the surgeon creates a hinge with the lamina, which opens up the spinal canal area. Tiny metal plates are used to bridge the newly created gap.