The laminae are two flat bony plates on the posterior portion of the spine that form part of the ring of bone surrounding the spinal cord.  Laminotomy means partial removal of the spine's laminae.  Laminectomy is the complete removal of the lamina. 

Laminotomy or laminectomy is performed to visualize and access the spinal cord, nerve roots, certain ligaments and intervertebral discs.

Surgical Goals

Both procedures are spinal decompression surgeries performed to decompress or remove pressure from the spinal cord and/or nerve roots, such as during a PLIF surgery. There are different types of spinal disorders, such as degenerative disc disease, herniated disc and spinal stenosis (Fig. 2) that may involve laminotomy or laminectomy. 

Surgical Procedure

Because laminotomy is a bone-sparing procedure, it is favored. However, your surgeon may decide to perform a laminectomy in order to enhance visualization and decompression.

Depending on your spinal disorder, the number of levels to be treated and other factors, surgery may be performed as an open approach or minimally invasive surgery (MIS). An open approach requires a long(er) incision and cutting through muscle and other soft tissues to gain access to the lamina.  Minimally invasive surgery uses small incisions (some puncture-like) and special equipment such as dilatational devices to gently separate muscle and soft tissue. Your surgeon will explain what your surgical procedure may involve and the intended benefits and possible risks and complications.

Selected ligaments in the surgical area are shaved or cut away. The ligamentum flavum, a large yellow spinal ligament, is one that often thickens and compresses nerves.  A small cutting tool is used to remove part or all of a lamina.  Bone spurs (osteophytes), disc fragments, and/or other tissue may be removed if they are part of the nerve root compression.

Potential Risks and Complications

• Spinal segment instability may result, particularly with laminectomy.
• Surgery may not resolve pain, tingling, numbness or weakness. In some cases, disc herniation and/or bone spurs can permanently damage nerves.  The longer a nerve is irritated, the longer it takes to heal.
• Additional treatment, such as medication or further surgery, may be needed.

We Can Help You Make Informed Decisions

Spine surgery is an important decision.  While the final decision is yours, the benefits, potential risks, and complications require careful consideration.  We look forward to answering your questions and helping you to resolve your concerns about any treatment offered by Piedmont Spine Center.