Microsurgical laminoforaminotomy is a method of surgical treatment of intervertebral disc hernia. In the Dworska Hospital, this surgery is performed within the cervical section of the spine.
The treatment involves cutting the laminae of the arches of two adjacent vertebrae, widening of the intervertebral foramen and removal of the nucleus pulposus which causes pressure on the nerve root or dural sac.
Indications for treatment
Surgical treatment is performed as part of the management of an intervertebral disc hernia, which leads to nonreducible pressure of the nucleus pulposus on the nerve root (brachialgy), the dural sac, or the spinal cord. Indications for treatment include:
- occurrence of limb muscle paresis (urgent surgery),
- no improvement despite the implementation of conservative treatment - rehabilitation, use of analgesics and anti-inflammatory drugs, steroid injection.
Laminoforaminotomy is performed in the case of lateral localization of the hernia, near the intervertebral foramen through which the nerve root extends to the periphery.
Course of treatment
The surgery is performed under general anesthesia. The patient is placed in a sitting position. The surgeon makes an incision of several centimetres on the patient’s neck. Then, the muscles are separated from the spinous processes and the arches of the two adjacent vertebrae are revealed, between which the rupture of the intervertebral disc has occurred. In order to gain access to the spinal cavity and the nucleus pulposus protruding inside of it, the surgeon cuts the laminae of the vertebral arches (laminotomy) and the medial part of the joint joining the vertebrae. He then widens the intervertebral foramen (foraminotomy) and removes the protruding nucleus pulposus, releasing the nerve root or the dural sac from compression. The surgery is carried out under the control of X-ray images, which enables the exact location of the hernia. The wound is closed with sutures. Sometimes it is necessary to place a drain in the operating field to remove blood to the outside. This reduces pain and facilitates healing.
Post-surgery proceedings
After the surgery, it may be necessary to stabilize the neck with a rigid orthopaedic collar. Standing up and walking is only allowed with the consent of the surgeon. The patient is discharged from the hospital after a detailed assessment of their general and neurological condition.
During the wound healing period, movements causing pain in the post-surgery area should be avoided. Sutures are usually removed on the seventh day after surgery. If absorbable sutures are used, they do not need to be removed as they are resorbed in the tissues.
For a period of 6-8 weeks after surgery, it is contraindicated to undertake physical activities and to make rapid turns or overburden the neck area. It is advisable to participate in rehabilitation during which the patient will be able to safely return to their everyday activities. The recovery period after the treatment depends on many factors. Of great importance is the course of the surgery itself (e.g. technical difficulties of the surgery related to individual anatomical differences of the operated area) and the patient’s compliance with the postoperative recommendations of the surgeon and physiotherapist.
FAQ
- How does laminoformatomy look like?
Laminoforaminotomy is a method of surgical treatment of intervertebral disc hernia. This surgery is often performed within the cervical spine.
The treatment involves cutting the laminae of the arches of two adjacent vertebrae, widening of the intervertebral foramen and removal of the nucleus pulposus which causes pressure on the nerve root or dural sac.
- What does recovery look like after surgery of the cervical spine?
In the early postoperative period, it may be necessary to wear an orthopaedic collar to stabilise the cervical part of the spine (if recommended by the physician). On the seventh day after the surgery, the operated area and the neurological condition of the patient are controlled and the sutures are removed. After this time, the patient should strictly follow the physician’s recommendations and participate in the rehabilitation. Recovery after the surgery is a very individual process, depending on the type of surgery performed, its course, the presence or absence of complications and the patient’s involvement in the rehabilitation process.
