The spinal column is made of a number on individual vertebral bones stacked on one another. These vertebrae have a hollow section around which the spinal cord is protected. Each vertebral bone is cushioned by an intervertebral disc. Occasionally it is necessary for a neurosurgeon or orthopedic surgeon to gain access to the spinal cord. One way of doing this is by performing a hemilaminectomy. A hemilaminectomy surgery may be part of a neurosurgery or its own therapeutic intervention.
A hemilaminectomy can be performed as a treatment for back pain that has not responded to medical or more conservative treatments. Often this is due to muscular strain or stress on ligaments and tendons, but in some cases parts of the spinal column are to blame. The spine does a good job at protecting the delicate spinal cord, but if parts of the spine touch or pinch the spinal cord, it can lead to pain, weakness, and abnormal sensations in the extremities.
The goal of spinal surgery to relieve pain or a pinched nerve to remove the parts of the spine that are causing the problem while at the same time preserving the structural integrity of the spine. Often the best place to do this on the spine is on the lamina (shown in the image). The lamina can be removed in a laminectomy procedure. When one side or only one lamina is removed, it is referred to as a hemilaminectomy. Hemilaminectomy surgery can usually provide pain and symptom relief but still allow the spine to support the weight of the body.
A hemilaminectomy is related and similar to a hemilaminotomy. The main difference between these two procedures is the amount of bone that is removed from the vertebra. More bone is removed during a hemilaminectomy than a laminotomy.
During hemilaminectomy surgery, the patient is placed in the “fetal position” so that the spinal column is exposed. In this position, the space between the vertebrae is stretched as much as possible. Generally the spine surgeon must move or remove the ligaments over the back of the spinal bones in order to gain access to the lamina. After the structures have been identified visually, the lamina is carefully cut and removed. It is extremely important not to damage the spinal cord or nerves during a hemilaminectomy.
Hemilaminectomy recovery can be challenging for the patient. A bit of pain and soreness is to be expected, though this is controlled with pain medications. While in bed, the patient will lie mostly on their side. Physical therapy and patient exercises may begin within a few hours into hemilaminectomy recovery. It is important to move the spine gently, but often, after the hemilaminectomy. This helps to restore flexibility to the spine as the area heals. Because the spine will not be able to support all of the weight right away, patients may need to use their abdominal muscles more to support the torso.
Over time, patients usually enjoy complete recovery from hemilaminectomy. Patients can often return to work within two weeks unless they have a career which requires a significant amount of physical labor.