What is a laminectomy?
A laminectomy is a decompressive procedure that removes the lamina — the flat bony plate forming the back wall of the spinal canal — to create more space for the compressed spinal cord or nerve roots. It is the most common surgical treatment for lumbar spinal stenosis and is also performed in the cervical and thoracic spine when decompression is required.
The procedure may be performed as a traditional open laminectomy through a midline incision or using minimally invasive tubular technique through one or two small incisions. Minimally invasive laminectomy preserves more of the surrounding musculature and stabilizing structures, resulting in faster recovery and less postoperative pain while achieving equivalent decompression.
Dr. Enguidanos performs both open and minimally invasive laminectomy at HCA Florida Twin Cities Hospital and Emerald Coast Surgical Center in Niceville, Florida. He serves patients throughout the Florida Panhandle and Gulf Coast with spinal stenosis causing leg pain, weakness, and difficulty walking.
The procedure.
Positioning
The patient is positioned prone on the operating table. For minimally invasive cases, fluoroscopy confirms the correct level before incision.
Exposure
Open: a midline incision exposes the posterior spine with retraction of the paraspinal muscles. Minimally invasive: a tubular retractor is docked at the affected level through a 1.5 to 2 cm incision.
Lamina Removal
The lamina is removed using a high-speed drill and Kerrison rongeurs. The extent of removal depends on the degree of compression — partial or complete laminectomy as required.
Ligamentum Flavum Removal
The thickened ligamentum flavum — a common contributor to stenosis — is removed with the lamina. Bilateral decompression may be achieved through a unilateral approach using the tubular technique.
Decompression Confirmed and Closure
The decompressed dural sac and nerve roots are confirmed to be free of compression. The wound is irrigated and closed. Most minimally invasive cases are outpatient.