| Intervention: Laminectomy |
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| Upper view of a human vertebra, showing the lamina | ||
| ICD-10 code: | ||
| ICD-9 code: | 03.09 | |
| MeSH | D007796 | |
| Other codes: | ||
Laminectomy is a spine operation to remove the portion of the vertebral bone called the lamina. The International Classification of Health Interventions (ICHI is a system of classifying Procedure codes being developed by the World Health Organization. ICD-9-CM Volume 3 is a system of Procedural codes. It is a subset of ICD-9-CM (volumes 1 and 2 are used for Diagnostic codes. Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books Procedure codes are numbers or alphanumeric codes used to identify specific health interventions taken by medical professionals Surgery (from the χειρουργική cheirourgikē, via chirurgiae meaning "hand work" is a medical specialty that uses operative manual and instrumental A vertebra (plural vertebrae) is an individual Irregular bone in the spinal or Vertebral column ( aka ischis a flexuous and flexible column There are many variations of laminectomy, in the most minimal form small skin incisions are made, back muscles are pushed aside rather than cut, and the parts of the vertebra adjacent to the lamina are left intact. The traditional form of laminectomy (conventional laminectomy)excises much more than just the lamina, the entire posterior backbone is removed, along with overlying ligaments and muscles. The usual recovery period is very different depending on which type of laminectomy has been performed: days in the minimal procedure, and weeks to months with conventional open surgery.
As pictured,the lamina is a posterior arch of the vertebral bone laying between the spinous process, which juts out in the midline, and the more lateral of each vertebra. The pair of lamina, along with the spinous process, make up the posterior wall of the bony spinal canal. The spinal canal (or vertebral canal or spinal cavity) is the space in Vertebrae through which the Spinal cord passes Although the literal meaning of laminectomy is excision of the lamina, the operation called conventional laminectomy, which is a standard spine procedure in neurosurgery and orthopedics, removes the lamina, spinous process and overlying connective tissues and ligaments,cutting through the muscles that overlie these structures. Neurosurgery is the surgical discipline focused on treating those central, Peripheral nervous system and spinal column diseases amenable to surgical Orthopedic surgery or orthopedics (also spelled orthopaedics) is the branch of Surgery concerned with injuries to or conditions involving the Minimal surgery laminectomy is a tissue preserving surgery that leaves the muscles intact, spares the spinal process and takes only one or both lamina. Laminotomy is removal of a mid-portion of one lamina and may be done either with a conventional open technique, or in a minimal fashion with the use of tubular retractors and endoscopes.
A lamina is rarely, if ever, removed because it itself is diseased. Instead, removal is done to: (1) break the continuity of the rigid ring of the spinal canal to allow the soft tissues within the canal to expand (decompression), or (2) as one step in changing the contour of the vertebral column, or (3) in order to allow the surgeon access to deeper tissues inside the spinal canal. Laminectomy is also the name of a spinal operation that conventionally includes the removal of one or both lamina as well as other posterior supporting structures of the vertebral column, including ligaments and additional bone.
Conventional open laminectomy often involves excision of the posterior spinal ligament, and some or all of the spinous process, and facet joint. Removal of these structures, in the open technique, requires cutting the many muscles of the back which attach to them. Laminectomy performed as a minimal spinal surgery procedure, however, allows the bellies of muscles to be pushed aside instead of transected, and generally involves less bone removal than the open procedure.
The success rate of laminectomy depends on the specific reason for the operation, as well as proper patient selection and technical ability of the surgeon. Indications for laminectomy include (1) treatment of severe spinal stenosis by relieving pressure on the spinal cord or nerve roots, (2) access to a tumor or other mass lying in or around the spinal cord, or (3) a step in tailoring the contour of the vertebral column to correct a spinal deformity such as kyphosis . Spinal stenosis is a medical condition in which the spinal canal narrows and compresses the spinal cord and nerves The spinal cord is a long thin tubular bundle of Nerves that is an extension of the Central nervous system from the brain and is enclosed in and protected Kyphosis (Greek - kyphos, a humpalso called "hunch back" in general terms is a common condition of a Curvature of the upper (thoracic spine The actual bone removal may be carried out with a variety of surgical tools, including drills, rongeurs, and laser.
The recovery period after laminectomy depends on the specific operative technique; minimally invasive procedures having a significantly shorter recovery period than open surgery. Removal of substantial amounts of bone and tissue may require additional procedures to stabilize the spine, such as fusion procedures, and spinal fusion generally requires a much longer recovery period than simple laminectomy. Spinal fusion, also known as spondylodesis or spondylosyndesis, is a surgical technique used to combine two or more Vertebrae.
Most commonly, laminectomy is performed to treat spinal stenosis.
--Laminectomy for Spinal Stenosis--
Spinal stenosis is the single most common diagnosis leading to any type of spine surgery, and laminectomy is a basic part of its surgical treatment. Spinal stenosis is a medical condition in which the spinal canal narrows and compresses the spinal cord and nerves The lamina of the vertebra is removed or trimmed to widen the spinal canal and create more space for the spinal nerves and thecal sac. A vertebra (plural vertebrae) is an individual Irregular bone in the spinal or Vertebral column ( aka ischis a flexuous and flexible column The spinal canal (or vertebral canal or spinal cavity) is the space in Vertebrae through which the Spinal cord passes The term spinal nerve generally refers to the mixed spinal Nerve, which is formed from the dorsal and ventral roots that come out of the Spinal cord. Surgical treatment that includes laminectomy is the most effective remedy for severe spinal stenosis, however most cases of spinal stenosis are not severe and do not require surgery. When the disabling symptoms of spinal stenosis are primarily neurogenic claudication, and the laminectomy is done without spinal fusion, there is generally a very rapid recovery with excellent long term relief. Neurogenic claudication ( NC) is a common "presentation" or one symptom of Spinal stenosis, or Inflammation of the Nerves eminating However, if the spinal column is unstable, and fusion is required, there is a recovery period of months to more than a year, and relief of symptoms is less likely.
The first laminectomy was performed in 1887 by Dr. Year 1887 ( MDCCCLXXXVII) was a Common year starting on Saturday (link will display the full calendar of the Gregorian calendar (or a Common Victor Alexander Haden Horsley, a professor of surgery at the University College London. Sir Victor Alexander Haden Horsley ( April 14, 1857 &ndash July 16, 1916) was an accomplished scientist and professor University College London ( UCL) is a multi-faculty university institution based in the United Kingdom and a constituent college of the University of London He was lauded for his breakthrough procedure.
A common type of laminectomy is performed to permit the removal or reshaping of a spinal disc as part of a lumbar discectomy. A discectomy is a Surgical procedure in which the central portion of an Intervertebral disc, the Nucleus pulposus, which is causing Pain by stressing This is a treatment for a herniated disc, bulging or degenerated disc.
Results of the surgical treatment.
However, in most known cases of lumbar & thoracic laminectomies, patients tend to recur pain/spinal stenosis for a period of 1 / 1. 5 years & tend to recover very slowly. According to a W. H. O. census, in 2001 most patients undergone lumbar laminectomy recovered normal functioning only after an year of their operation.
See Also
External links
- [1] Explanation and illustration of minimal spine surgery laminectomy
Dictionary
laminectomy
-noun
- (surgery) The surgical procedure to remove the bony arch or lamina from one or more vertebrae.
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