Nerve Decompression Surgeries
Lumbar Discectomy/Microdiscectomy OR/ AND Laminotomy, Laminectomy or Hemilaminectomy:
These are all for releasing pressure on the nerve root or spinal cord.
A- Normal (seen from back) B - Hemi-laminectomy where lamina one one side is removed; C- Laminectomy- lamina on both sides is removed.
Laminotomy- lamina is not removed, but a cut is made in it to relieve pressure on the nerve
Difference: laminectomy is removal of lamina; laminotomy is a small piece removed from the lamina
Discectomy:
Herniated portion of the disc is removed through a cut/ hole in the lamina or through hemilaminectomy/ laminectomy.
When are these done?
Urgent:
infection, tumor, severe or worsening weakness, inability to control urine or stool, unable to feel in the saddle area, bleeding, fractures/ dislocations
Non urgent:
Tests show herniated discs, or cysts, or other factors causing narrowing/ pinching of nerves/ spinal cord that correspond to your area of pain or numbness
Severe pain, primarily going down legs, affecting daily activities or brought on by walking or certain postures
AND all other sources of pain excluded ( including psychological/ behavioral)
AND your exam shows nerve exam problems or special test abnormalities
AND you tried at least 2 of medicines, exercise program, spine injections for atleast 6 weeks with no/ minimal benefit
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