What Is Microlaminectomy and Microlaminotomy?
Microlaminectomy and microlaminotomy are types of minimally invasive spine surgery. Like microdiscectomy and microforaminotomy, they are a type of decompression procedure that takes pressure off your nerves and spinal cord, which can help reduce your back pain and/or leg pain.
Surgeons have been doing traditional open laminectomies and laminotomies a lot longer than microlaminectomies and microlaminotomies, but the traditional open approaches have a few drawbacks.
They often involve a large incision, as well as more cutting of your back muscles and tissues. Also, recovery from open spine surgery sometimes can be painful and slow.
However, whether you have a traditional laminectomy (or laminotomy—the difference is explained below) or a microlaminectomy, the goal is the same: to relieve your pain.
When Is a Microlaminectomy or Microlaminotomy Used?
The lamina is a bony part of your spine, and it makes up part of your spinal canal. You can think of it as the "roof" of your spine.
A laminectomy (the total removal of the lamina) or a laminotomy (removing part of the lamina) is used for 2 reasons:
- To relieve nerve or spinal cord compression caused by your lamina
- To gain better access to other parts of your spine: Parts of your lamina may need to be removed so that your surgeon can reach your disc, for example. Then he or she can do a microdiscectomy.
How Are Microlaminectomy and Microlaminotomy Performed?
A microlaminectomy and microlaminotomy can be performed using one of these techniques:
- Mini-open: This is similar to an open laminectomy and laminotomy, but with this technique, your surgeon uses special surgical tools and instruments to view your spine through much smaller incisions.
- Tubular: With this technique, your surgeon inserts a tube through a very small incision and gently pushes it through your back muscles until it gets to your spine. Then, your surgeon inserts a series of progressively larger tubes, one right around the other. These tubes gradually open up the area where your procedure will be done, and then your surgeon performs the surgery through the tube with special tools.
- Endoscopic: With this technique, a tiny video camera, which is called an endoscope, is inserted through a tube, which enables your surgeon to see your spine. Miniaturized instruments are then used to remove the necessary bone.
You'll be lying down on your stomach during a microlaminectomy or microlaminotomy, and typically, you'll have general anesthesia. Using one of the techniques mentioned above, your surgeon will remove part or all of your lamina, depending on your condition.
A microlaminectomy or microlaminotomy usually takes less than 1 ½ hours to perform.
Microlaminectomy and Microlaminotomy Risks
In addition to the typical complications of surgery, such as blood loss during surgery and post-operative pain, there are additional risks for microlaminectomy and microlaminotomy:
- Your back and/or leg pain might return.
- You may have a suboptimal decompression. That means that not enough bone is removed and you still have symptoms. This is a major drawback of endoscopic procedures.
- Your spinal cord, nerves, and blood vessels can be injured.
Microlaminectomy and Microlaminotomy Recovery
Microlaminectomy and microlaminotomy are attractive options because patients can quickly return to their normal lives. Your doctor will let you know when you can return to exercising and other typical activities.