What is the Lumbar Hemilaminectomy Surgery?

Various spinal surgical treatments are available to relieve spinal cord and nerve compression. And they are commonly used to treat problems such as spinal stenosis, spondylolisthesis, slipped discs, and others.

One common type of spinal decompression surgery is lumbar hemilaminectomy. Although lumbar hemilaminectomy and lumbar laminectomy are both lower spine procedures, there are a few important differences.

Read on to discover the differences between lumbar hemilaminectomy and laminectomy, and what are possible non-surgical or minimally invasive options for hemilaminectomy.

What is the spinal lamina?
Before we get into lumbar hemilaminectomy surgery, it's important to understand the function of the laminae in your spine. Each spinal bone, known as a vertebra, has two laminae covering the spinal canal and providing protection.

Within a vertebra, the lamina connects the spinous and transverse processes. The spinous process is a little bone protrusion from the rear of the spinal cord. And the transverse process is another bone protrusion that connects the back muscles and ligaments to the spine.

Lumbar hemilaminectomy vs. laminectomy
Lumbar hemilaminectomy and laminectomy are both types of spinal decompression surgery for opening up additional space in the spinal canal and resolving nerve compression, but there is a major difference between these procedures.

A laminectomy involves the removal of both laminae from the targeted vertebrae. In hemilaminectomy, however, a surgeon discards only the lamina on the side of the spinal canal under nerve compression.

Patients who need decompression on both sides of the spinal canal will almost certainly need a laminectomy rather than a hemilaminectomy.

Thoracic and cervical hemilaminectomy and laminectomy are also options. However, they are less common.

When is the laminectomy required?
The laminectomy is most often performed to treat spinal stenosis. This condition is characterized by the gradual reduction of space in the spinal canal and can lead to nerve compression.

Symptoms of spinal stenosis include back pain, cramping in the legs, sciatica, pins, and needles, or heavy sensation in the legs, feet, or buttocks.

Laminectomy alleviates spinal stenosis symptoms by relieving pressure on the spinal nerves. A laminectomy can also improve the environment for the injured tissue to heal by making more room in the spinal canal.

When hemilaminectomy required
A hemilaminectomy treats a herniated disc, also known as a slipped or ruptured disc. This common spinal injury can cause pain, stiffness, and tingling or weakness in the legs.

A cushion-like disc (intervertebral disc) between each vertebra of the spine protects the vertebrae by absorbing impact and allowing movement.

Intervertebral discs can be destroyed due to age-related changes in the spinal discs, a sudden injury to the spine, or recurrent strain on the spine. A herniated disc occurs when the soft interior of the disc protrudes from a rupture in the tough outer layer of the disc.

If non-invasive treatment approaches do not relieve the symptoms of a herniated disc, patients may require both hemilaminectomy and discectomy.

Spinal Fusion With Lumbar Hemilaminectomy
Spinal fusion may be performed to prevent spinal instability after lumbar hemilaminectomy. The damaged vertebrae are grafted using bone graft material during this spinal operation. The graft will accelerate bone growth and unite the vertebrae, resulting in one bone.

Although spinal fusion can provide stability in lumbar hemilaminectomy, the recovery period typically lasts a total of around 4 to 6 weeks. But some patients may require a year or more to make a full recovery after spinal fusion.

While spinal fusion can effectively avoid instability following hemilaminectomy, it carries a significant risk of restricted mobility. Patients who undergo spinal fusion frequently lose spine flexibility and are unable to bend or flex the spine as they once could.