A hemilaminectomy is a surgical procedure, classically performed by a spinal surgeon, which is designed to relieve pressure on the nerves in the spine. This procedure is performed when patients have degenerative conditions leading to nerve damage or pain, causing discomfort and a loss of functionality for a patient. Because the procedure is invasive, it is usually only recommended when other treatment approaches have not worked and the surgeon feels that it is in the patient's best interest.
In the procedure, a surgeon removes the laminae, a part of the vertebrae, in an area of the spine. The procedure is known as a hemilaminectomy because the surgeon only removes the lamina from one side of a vertebra, rather than both, to maintain as much stability as possible. In a full laminectomy, the laminae from both sides are removed. Removing this structure creates more room for the nerve, relieving pressure and pinching.
Before the procedure can be performed, a neurological exam is conducted to determine which area of the spine is affected. The surgeon also typically orders medical imaging studies of the spine so that he or she can clearly visualize the area that requires surgery. The patient undergoes routine blood work to check for underlying medical problems that could complicate surgery, and meets with an anesthesiologist to discuss anesthesia options and prepare for the operation.
A hemilaminectomy is performed under general anesthesia, with the patient lying face down on a table designed for spinal surgery. As in other surgical procedures, the area is carefully cleaned and isolated with drapes. The length of the procedure can vary, since surgeons usually take their time, and they also order imaging studies during the operation to confirm their work, because they want to avoid making a mistake.
Pain after surgery is managed with the use of analgesic medications. The patient is usually hospitalized for several days so that he or she can be monitored for the signs of complications. Risks of the procedure can include infection at the wound site, kidney or bladder infections, nerve damage, spinal fluid leaks, or blood clots. Rarely, a patient may become paraplegic if the spinal cord is damaged. The risk of complications is greatly reduced by going to a skilled surgeon with a great deal of experience, and taking time during pre-surgery preparation to confirm that the surgeon has as much information as possible about the patient's medical history and condition.