Microlaminoforaminotomy

Microlaminoforaminotomy

Microlaminoforaminotomy is a keyhole surgical procedure conducted from the posterior spine to treat lateral disc herniation in the neck. By using this technique, surgeons can avoid injury to the delicate structures in the front of the cervical spine and retain the mobility of the section of vertebrae treated. This type of surgery is often considered where patients are suffering from radicular pain, paraesthesias, neck pain, problems with motor skills, and loss of sensation, or numbness, due to a cervical disc herniation. Operations are performed at a single level, commonly in the C6-C7 vertebrae, although C5-C6, C7-Th1, and all the other cervical levels have been successfully operated on using this technique.

During Neck Surgery

Additionally, this type of neck surgery allows the surgeon to remove just part of the herniated disc, rather than having to remove the whole disc as occurs in anterior cervical discectomy. Surgeons can also remove any osteophytes that are further contributing to cervical spinal stenosis. Decompression of the spine, occurs in the majority of patients to some extent with significant reduction in radicular pain often experienced very quickly after surgery due to the relief of pressure on the cervical spinal nerves. Kunert (2010) reports complete or marked improvements in radicular pain in 95% of patients undergoing this procedure in one study, with similar results for neck pain (94%), sensory loss (82%), and motor deficit (78%). Encouragingly, the study also showed that no spinal instability occurred or the necessity for secondary surgery after an average of 22 months.

A Minimally Invasive Procedure

As the surgery is done through the use of tube retractors, it is minimally invasive with the muscles spread, rather than cut, to gain access to the cervical spine. A very small (3mm) hole is cut in the lamina and the herniated disc material or osteophyte growth is removed through this window. The procedure minimizes trauma to the surrounding muscles and tissues making recovery times much shorter than for more conventional open procedures such as a full laminectomy with herniated disc removal. The minimal removal of structural material, the lamina, for example, means that fusion is unnecessary which avoids the risk of extra pressure being put on adjacent segments. The lack of required secondary surgery demonstrates this improved rate of stability in the cervical spine achieved by a microlaminoforaminotomy as compared to laminoplasty, laminotomy, laminectomy, and other spinal surgeries.

Recovery

Patients usually leave the hospital within 24 hours and schedule a follow-up appointment for a couple of weeks later in order to assess progress. Treatment after surgery may include the short-term use of analgesics to alleviate any post surgical tenderness, but pain usually improves very quickly and damage and inflammation in the surrounding tissues is minimal due to the nature of the surgery. As with any operation there is a risk of problems, with patients needing to be watchful for signs of infection or post-surgical complications once they have returned home.

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Last Updated: 11/03/2010