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Laminectomy and foraminotomy

Definition

Foraminotomy is surgery that widens the opening in your spine where nerve roots leave the spinal canal.

Laminectomy is surgery to remove the lamina, part of the bone that makes up a vertebra. Boney growths or spurs in your back will be removed.

These procedures take pressure off the spinal nerves and allow them to move more easily. They also open up your spinal canal to take pressure off your spinal cord.

Description

You will receive anesthesia, medicine that blocks pain, during the surgery. You will not feel any pain.

  • You will lie face down on the operating table for surgery on your back, or you may sit up on the operating table for surgery on your neck. A cut (incision) is made in the middle of the back of your spine. The length of the cut depends on how much of your spinal column will be operated on.
  • Skin, muscles, and ligaments are moved to the side. Your surgeon may use a surgical microscope to see inside your back.

The next steps depend on the results of an MRI scan and what the surgeon observes in your spine:

  • Some bone is cut or shaved away to open the nerve root opening (foramen). Any disk fragments are removed.
  • Part or all of the lamina bones may be removed on both sides of your spine. Other bone spurs or growths may also be removed at the back or sides of the vertebrae to make more room.
  • If your surgeon is worried that your spine will not be stable after the bone has been removed, you may also need to have spinal fusion.
  • The muscles and other tissues are put back in place, and the skin is sewn together.

Why is the procedure done?

Laminectomy and foraminotomy are most often done to treat spinal stenosis, the narrowing of spaces in the spine. You will have an MRI to find out whether spinal stenosis is causing your symptoms.

These surgeries may be done if you have severe symptoms that interfere with your daily life. You and your doctor can decide when you need to have surgery for these symptoms. Although spinal stenosis symptoms often become worse over time, this worsening may happen very slowly.

If you are having problems with your bowels or bladder due to the spinal stenosis, you will need to have surgery right away.

How well does surgery for spinal stenosis work?

Even when using MRI scans or other tests, it is hard to predict which patients will improve and how much relief surgery will provide.

People who had chronic back pain before their surgery will likely still have some pain afterward. These surgeries often can't take away all the pain and other symptoms.

Lose weight, if needed, and get exercise to increase your chance of feeling better.

Future spine problems are possible for all patients after spine surgery. If spinal fusion is done, the area that was fused together can no longer move. This means the areas of the spinal column above and below the fusion are more likely to be stressed when the spine moves and have problems later.

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Review Date: 4/3/2018

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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