Laminectomy

Laminectomy is the resection of the lamina of a vertebral body. By removing the lamina the spinal canal is decompressed reducing pressure on the spinal cord / cauda equina.

When only one of the lamina is resected the terms hemilaminectomy or unilateral hemilaminectomy can be used depending on regional preferences.  

Laminectomies are most commonly performed in the lumbar spine ref. They can be an open or minimally invasive procedure. When minimally invasive, unilateral laminectomy for bilateral decompression (ULBD) is the predominant technique 3. Laminectomies are often accompanied by facetectomy, foraminotomy and/or instrumented spinal fusion 2

  • stripping of the paraspinal muscles from the spinous process
  • removal of the spinous processes
  • removal of the lamina (either piecemeal or en bloc) and identify the ligamentum flavum origin
  • resection of the ligamentum flavum 1,5
  • introduction of a tubular retractor over K-wire onto a facet joint with removal of attached soft tissues
  • use of endoscope and operative microscope
  • ipsilateral laminectomy and medial facetectomy performed using a high-speed drill with removal of ipsilateral ligamentum flavum
  • "wanding" of the tubular retractor allows for undercutting of the spinous process and contralateral laminectomy then ligamentum flavum resection 3,4,6
  • immediate post-operative complications are similar between the two groups 3
    • intraoperative dural injury
    • wound infection
    • CSF leak
  • spinal instability may be more common in open vs minimally invasive approaches 3
  • open laminectomy has a success rate for treating lumbar spinal stensois of ~65% (range 62-70%) 3

Article information

rID: 52822
Synonyms or Alternate Spellings:
  • Minimally invasive decompressive (MID) lumbar laminectomies
  • Unilateral laminectomy for bilateral decompression (ULBD)
  • Unilateral hemilaminectomy
  • Hemilaminectomies
  • Laminectomies
  • Hemilaminectomy
  • Spinal decompression

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Cases and figures

  • Case 1: lumbar
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  • Case 2: lumbar
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  • Case 3: thoracic
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  • Case 4: L5/S1 hemilaminectomy
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