Thoracic laminectomy is a procedure that is performed through the posterior portion or back of the spine to relieve pressure on the nerves or spinal cord. Laminectomy means "removal of a lamina." The lamina is the roof of the spinal canal. Removal of this structure allows for additional room for the spinal cord and the nerves [Figure 1]. Laminectomy can be used to treat spinal stenosis or for other conditions that may lead to compression of the spinal cord and nerves, including tumors, infection or as part of a procedure to correct spinal deformity.
To perform a thoracic laminectomy an incision is made in the center of the mid back over the area affected. The muscles are then moved to the side. Once the spine is reached, the vertebra is identified. The lamina of the affected vertebra is then removed. Any bone spurs or material causing pressure on the nerves is removed as part of this procedure [Figure 2]. The amount of material that is removed depends on the specific condition for each patient. For some patients, removal of the facet joints or other structures is also required.
In some cases the procedure requires removal of the supporting structures around the spine. In these cases addition of a spinal fusion may be required in order to prevent problems with stability after the surgical procedure. In some cases spinal instrumentation is also utilized to maximize the chances for a successful fusion.
Please refer to the section on Instrumented Fusion for further information.