Minimally Invasive Laminotomy/Discectomy
What is it?
Minimally invasive lumbar laminotomy/discectomy is an operation performed on the lower spine to relieve pressure on one or more nerve roots. The term is derived from the words lumbar (low back), and discectomy (remove a portion of the intervertebral disc).
Why Is It Done?
When an intervertebral disc ruptures in the lumbar spine, it puts pressure on one or more nerve roots (often called nerve root compression). This causes pain and other symptoms in the neck, arms, and even legs. In this operation, the surgeon reaches the lumbar spine through a small incision in the low back. After the muscles of the spine are spread, the nerve root is exposed by removing part of the bony covering (lamina), which covers the nerve root. This is called a laminotomy. If necessary a portion of the intervertebral disc is then removed taking the pressure off of the nerve root.
What Happens Afterwards?
At home you will have medication to help with any discomfort. Any severe increase in pain not controlled with the medication should also be reported to your physician or the physician's nurse. You should report any elevation in your temperature, drainage from you incision, or increase in numbness or weakness.
Successful recovery from a lumbar laminotomy/discectomy requires that you approach the operation and recovery period with confidence based on a thorough understanding of the indications, alternatives, and risks of your procedure. The better informed you are the better prepared you will be for the post operative period. Do not hesitate to ask questions and be certain that you clearly understand the answers. Your surgeon has had training and has the expertise to perform the operation; he or she and the rest of the health care team will support your recovery. Your body will work to heal the involved muscle, nerve, and bone tissues. Full recovery, however, will also depend on you having a strong, positive attitude, setting small goals for improvement, and working steadily to accomplish each goal.
The surgery can be done with you totally asleep or with an injection of numbing medicine in your spine. An intravenous catheter will be started and then the anesthesiologist will use IV medications to make you comfortable. A catheter may be placed in your bladder if the surgery is planned to take a long time.
Surgery for minimally invasive lumbar laminectomy/discectomy is performed with the patient lying on his or her stomach with a small incision made in your low back.
|Exposure and Decompression of the Nerve Root
The METRx® System is used to gain access to the spine by separating the fibers of the skin and muscle. A microscope or an endoscope is used to look down the tube and visualize the spine. The bone over the nerve root is exposed and then a portion of this is removed to expose the nerve root. The disc is visualized underneath the nerve root. Part of the disc is removed with special instruments taking any remaining disc pressure off of the nerve.
The operation is completed when the low back incision is closed in several layers. Dissolving suture material is used and a waterproof dressing is applied so that you can shower.
The anesthesiologist awakens you and you are watched in the recovery room. You then go to your room and may go home that day or the next day. You will be given medication to control any discomfort.
Click here to read about patient who has had this procedure.
Technique contributed by Dr. Sylvain Palmer.
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It is important that you discuss the potential risks, complications, and benefits of the METRx® System with your doctor prior to receiving treatment, and that you rely on your physician's judgment. Only your doctor can determine whether you are a suitable candidate for this treatment.
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