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A microlaminectomy is a surgical option to relieve pressure on nerves or parts of the spinal cord. It’s a procedure sometimes considered if conservative (non-surgical) treatments for back or radiating nerve pain felt in the thighs or legs aren’t effective.
- A microlaminectomy is a minimally invasive version a traditional laminectomy.
- For patients who are candidates for the procedure, it often means fewer risks and a faster recovery.
Conditions Treated with a Microlaminectomy
Structural sources of nerve compression are treated with a microlaminectomy. The procedure is often recommended to ease nerve pressure from disc damage. This includes nerve pressure from protruding inner disc material (disc herniation) or from one disc slipping forward over the adjacent one (spondylolisthesis). The surgery may also be performed to allow better access to a damaged disc that will need to be removed. The operation may also be recommended if nerve-based pain is linked to:
- Lumbar spinal stenosis
- Bone spurs
How a Microlaminectomy is Performed
During the procedure, a portion of a bony part of the spine called the lamina is removed to ease pressure on nerve roots. The surgery is an alternative to traditional open procedures that require large, single incisions. It’s performed with a series of smaller incisions that are usually less than a few inches in length.
Special tools and instruments are used to guide the surgeon to the affected area of the spine and remove part of the lamina. Because smaller incisions are made, disruptions to nearby muscles and other structures are minimal, which typically results in quicker healing and less risk of unintended damage to nerves. The surgery is usually completed within a few hours.
Surgeons performing a microlaminectomy often opt for one of three possible techniques. The determination of which technique to use will depend on factors such as the location of the affected part of the spine.
A mini-open microlaminectomy is similar to traditional open surgery, except smaller incisions are made and special surgical tools are used. With a tubular microlaminectomy, a tiny tube is inserted through a small incision to reach the affected area of the spine. Progressively larger tubes are inserted to make space for the surgery to be performed with special instruments.
Another minimally invasive microlaminectomy technique involves the use of an endoscope, a special tool with a small video camera attached to it. The endoscope is inserted through a tube to allow the surgeon to view the affected area. The lamina is then removed with specialized instruments.
Meant for short-term use, pain medications are often prescribed to help manage pain as tissues heal. Patients are encouraged to walk and move around as much as possible as healing and recovery progress.
As with other minimally invasive surgeries, ideal candidates for a microlaminectomy are usually patients who are otherwise healthy without other significant sources of back or nerve pain. Physical therapy that includes light exercise is often recommended to recondition muscles and restore flexibility and range of motion. A complete return to normal activities typically takes about 4-6 weeks.