Distinguish among laminotomy laminectomy and laminoplasty

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All three procedures are performed through a posterior approach and are intended to provide posterior decompression of neural structures.

A laminotomy consists of partial lamina or facet joint removal to expose and decompress the nerve root and/or dural sac (see Fig. 23-1B).

A laminectomy consists of removal of the spinous process and the entire lamina to achieve decompression (see Fig. 23-1C).

Figure 23-1. Lumbar decompression. A, Preoperative. B, Laminotomy. C, Laminectomy.

A laminoplasty provides decompression of the neural elements by enlarging the spinal canal with a surgical technique (Fig. 23-2) that avoids removal of the posterior spinal elements. Various laminoplasty techniques permit preservation and reconstruction of the posterior osseous and ligamentous structures of the spinal column without the need for fusion. Laminoplasty techniques are most commonly utilized in the cervical spine.

Figure 23-2. Cervical laminoplasty: A, Preoperative. B, Postoperative.

Figure 23-2. Cervical laminoplasty: A, Preoperative. B, Postoperative.

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