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Minimally Invasive Spine Surgery - Kraus Back & Neck Institute
MISS is the acronym for Minimally Invasive Spine Surgery. It has changed how neurosurgeons operate today. MISS techniques reduce the need for large incisions, muscle cutting, and a long period of recovery. Instead, your neurosurgeon uses highly refined instruments, tools, devices...
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Spinal Surgery

Laminotomy

Laminotomy is a surgical procedure involving the removal of a part of the lamina to relieve pressure over the spinal cord or nerve roots. “Lamina” is a bony plate or layer that covers and protects the spinal cord, and “otomy” means partial cutting. The aim of the surgery is to alleviate pressure over the spinal nerves or spinal cord.

A laminotomy may also be performed as a part of discectomy.  A discectomy is a surgical procedure to remove the herniated disc that is exerting pressure over the spinal cord or the nerves surrounding the spinal cord.

A laminotomy is also employed to remove the ligamentum flavum, a yellow ligament that connects the laminae of the vertebrae. As a part of the aging process, the ligamentum flavum can thicken, compressing the spinal cord and nerve roots, resulting in spinal stenosis. Through a laminotomy, the ligamentum flavum is removed to relieve the pressure over the spinal cord or nerve roots.

Some spinal conditions may also be treated with a laminotomy and include cervical and lumbar spinal stenosis, cervical and lumbar herniated disc, cervical radiculopathy, degenerative disc disease, spondylosis, and tumors causing arm or leg pain by e compression of the spinal nerves

Before surgery

Your doctor will discuss the type of procedure as well as its associated risks and benefits with you. A general health clearance letter from your physician is required for surgery. Blood tests, X-rays, or other imaging tests may also be required to evaluate your medical condition.

Procedure

The patient is administered general anesthetic and placed in a face down position.  X-ray or fluoroscopic guidance helps the surgeon visualize the operating field during the procedure. X-rays are taken to confirm the level of the spinal injury.. An incision is made over the identified spinal level and the muscles and soft tissues are moved apart to expose the lamina.  A portion of the lamina is removed to open the spinal canal and access the spinal cord and nerve roots. The spinal cord and/or the nerves are decompressed and the incision is closed. 

Laminotomy is a minimally invasive procedure; meaning it utilizes small incisions without damaging the muscles and soft tissues.

After surgery

After the surgery, you will be transferred to a recovery room where your vital signs will be closely monitored by the medical staff.  Mild discomfort, pain at the incision site, neck or back muscle spasms, or other related symptoms may occur after the surgery. Your doctor may recommend a cervical or lumbar brace to provide stability and support during the healing process.

Post-operative care

Keep your incision area clean and dry. Avoid heavy lifting, smoking, driving, and using hot tubs and swimming pools. Physical therapy can be started as guided by your doctor. Medications should be taken as prescribed by your doctor.  You will need to arrange a follow-up appointment with your doctor to assess your recovery.

Risks

The potential risks and complications with laminotomy include infection, bleeding, problems with anesthesia, and nerve injury.

Call your doctor if have any signs of infection such as pain, redness, swelling, or alteration in the quantity or smell of the drainage, or fever over 101° F. You must also inform your doctor if you experience bowel and bladder dysfunction or numbness over the genital area.

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