laminektomi

Laminektomi, or laminectomy, is a surgical procedure that removes part or all of the lamina, the back part of a vertebra, to decompress the spinal canal and relieve pressure on the spinal cord or nerve roots. It is used to treat conditions that narrow the spinal canal or irritate neural structures, such as spinal stenosis, herniated discs, tumors, trauma, or infection. The surgery can target the cervical, thoracic, or lumbar regions, most commonly the lumbar spine for leg-dominant symptoms.

Indications and variants include central laminectomy, which removes the entire lamina from a vertebra, and laminotomy, which removes only a portion of the lamina to decompress specific nerve roots. Laminoplasty is a related technique that reopens the canal by reshaping and repositioning the lamina rather than removing it, and it is used in some cases of cervical myelopathy. Laminectomy can be performed at one level or multiple levels depending on the extent of compression.

Procedure and considerations: Laminektomi is usually performed under general anesthesia through a posterior approach. The surgeon removes the laminae and often the ligamentum flavum to relieve pressure on neural elements. Preservation of facet joints aims to maintain stability, and additional fusion or instrumentation may be considered if there is preexisting instability or after extensive bone removal.

Recovery and risks: Hospital stays vary, with rehabilitation lasting weeks to months. Benefits often include relief of leg pain and sensory symptoms, though back pain may persist. Risks include infection, bleeding, dural tear with cerebrospinal fluid leak, nerve injury, spinal instability, blood clots, and anesthesia-related complications. Outcomes are generally favorable in appropriately selected patients.