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Lumbar Laminotomy/Foraminotomy

What does “Lumbar Laminotomy and Foraminotomy” mean?

  1. Lumbar: part of the spine located in the low back
  2. Laminotomy: removal of a piece of the lamina bone of the back of the spine
  3. Foraminotomy: removing some bone pieces to make the hole for the spinal nerve larger

Altogether, “Lumbar Laminotomy, Foraminotomy” means removing a small piece of bone from the lamina of the low back in order to be able to see the spinal nerve and free it up by removing bone from around the nerve.

What is a Lumbar Laminotomy and Foraminotomy?

A Lumbar Laminotomy and Foraminotomy is a surgery done in the low back to free up a spinal nerve which is trapped by bone spurs. A piece of bone from the lamina on the back of the spine is removed (laminotomy) so that the opening for the spinal nerve (foramen) can be seen. Bone spurs are then removed from around the spinal nerve in the foramen (foraminotomy).

Why is a Lumbar Laminotomy and Foraminotomy done?

This surgery is done for nerve compression from bone spurs which narrow the lumbar foramen.

 How is a Lumbar Laminotomy and Foraminotomy actually done?     

Here are some of the steps of how this surgery is done:

  1. An intravenous catheter (IV) is placed in the patient and antibiotics are given.
  2. This surgery is done in an Operating Room.
  3. The patient is placed under General Anesthesia while lying on their back (supine).
  4. The patient is then carefully placed on their stomach (prone) on the operating table.
  5. The low back is now cleaned with a surgical antiseptic and plastic covers (drapes) are placed around the area where the surgery will take place.
  6. The surgeon then makes the initial cut (incision) in the center of the spine.
  7. The softer tissues (fat, fascia) are then divided with a cautery until the tips of the spinous processes (tips of the spine) are seen.
  8. The muscle attachments to the back of the vertebra are then carefully separated from the bone and the muscles pushed to the sides with retractors (metal devices to help see deeper structures).
  9. Often X-Rays are taken to make sure the surgeon knows this is the correct level in the spine.
  10. The lamina is now clearly visible and often thinned using a burr (similar to dentist’s drill).
  11. Once the lamina is quite thin, it is carefully removed with very delicate, small instruments until the spinal nerve can be seen.
  12. The nerve is carefully inspected and any further bone or disc material is removed until it is completely freed up. The foramen is inspected (probed) to make sure that no obstruction is left around the nerve.
  13. The main part of the surgery is now complete.
  14. The retractors are removed
  15. The tissues and skin are closed.
  16. A bandage (dressing) is placed over the wound.
  17. The patients is carefully rolled back on their back (supine) and awoken from Anesthesia.
  18. The patient is then brought to the Recovery Room.

How long does a surgery like this take?

A Lumbar Laminotomy and Foraminotomy often takes 1-2 hours to complete for a single spinal level.

What is the recovery from a Lumbar Laminotomy and Foraminotomy like?

Here are some of the steps during a recovery from this type of surgery:

  1. The patient is usually admitted to the hospital for at least an overnight stay.
  2. After discharge, activity restrictions about lifting, bending, twisting, running, etc. will be given.
  3. The wound will heal in 2-4 weeks.
  4. The surgeon will typically evaluate the patient again within several weeks.

What kind of benefit can patients gain from a Lumbar Laminotomy and Foraminotomy?

A Lumbar Laminotomy, Foraminotomy will remove pressure on the spinal nerve. The symptoms often improve over weeks and months following the surgery.

Depending on how long a nerve was compressed and the severity of the compression, some symptoms may remain.