Planning for spine surgery is a big step. There are often several options to consider, and choosing the correct one is key to finding relief. NU-Spine: The Minimally Invasive Spine Surgery Institute, with several locations in New Jersey, offers a full range of spine surgeries to ensure patients access to the right treatment. Here, we discuss thoracic hemilaminectomy vs. laminectomy and when each is recommended.
Key Takeaways
- A thoracic laminectomy removes all the lamina, or the back section of the spine, on one or more vertebrae. A thoracic hemilaminectomy removes only part of the lamina.
- Thoracic hemilaminectomy is a less invasive procedure, allowing for less post-surgery pain, a lower risk of complications, and a faster recovery.
- Each procedure is appropriate for a different situation depending on the severity, extent, and cause for a patient’s spinal cord compression.
Understanding Thoracic Spine Anatomy
The spine is a long chain of interlocking bones called vertebrae. Each vertebra is shaped like a bony ring. Pairs of vertebrae are separated by rubbery spinal discs that act as shock absorbers. Through the center of the entire spine runs a gap, called the spinal canal, which is where the spinal cord is located. The spinal cord is a bundle of nerves that relay information between the brain and the body. The structure of the spine serves to support and protect the spinal cord.
Spinal stenosis occurs when the spinal canal becomes narrowed, usually by a bone spur or herniated spinal disc. This reduces the amount of space around the spinal cord. The nerves become compressed or impinged and can no longer send information correctly. Patients experience intense pain and neurological symptoms as a result – a condition known as myelopathy.
What Is a Thoracic Laminectomy?
A thoracic laminectomy is a surgery performed on the thoracic, or middle back, section of the spine. The procedure involves removing the lamina, or the back section of a vertebra. The lamina is responsible for supporting the spinal cord. Removing it is a standard treatment for many conditions that cause (spinal cord compression), including:
- Thoracic herniated disc
- Spinal osteoarthritis
- Bone spurs
- Scoliosis
- Degenerative disc disease
By removing the lamina, surgeons create additional space around the spinal cord. As a result, the spinal cord has room to function without becoming compressed. A laminectomy may also be required as part of other procedures. For instance, a thoracic laminectomy may be performed to create access to a herniated disc for the purposes of a thoracic discectomy.
What Is a Thoracic Hemilaminectomy?
Hemilaminectomy means “half a laminectomy.” Appropriately, a thoracic laminectomy can be thought of as a partial thoracic laminectomy. The procedure is performed similarly to a laminectomy – rather than remove the whole lamina, surgeons remove only part of it. This relieves spinal cord compression while leaving most of the vertebra intact.
Because less of the bone is removed, hemilaminectomy offers several advantages over a traditional laminectomy. It carries less risk of spinal instability requiring a thoracic spinal fusion. It is also less invasive, meaning the surgery’s impact on the body is reduced. This allows for less post-surgical pain, reduced infection risk, and faster recovery. As a result, thoracic hemilaminectomy is generally preferred over laminectomies when possible.
Hemilaminectomy vs. Laminectomy Indications
Both thoracic laminectomy and thoracic hemilaminectomy share a similar goal: to relieve pressure from the spinal cord. Because the surgeries are slightly different in their methods, they are most appropriate in certain situations. The patient’s medical team uses imaging to carefully evaluate the severity, extent, and causation of their condition before recommending treatment.
Patients may get a hemilaminectomy based on these factors:
- Severity: The spinal stenosis is mild, causing only minor symptoms.
- Extent: The spinal stenosis is present only in a specific location.
- Cause: The spinal stenosis is caused by a bone spur or herniated disc.
Patients may need a full laminectomy in the following cases:
- Severity: The spinal stenosis is severe, causing significant pain and loss of function.
- Extent: The spinal stenosis is widespread or comes from multiple directions.
- Cause: The spinal stenosis is caused by the lamina itself, usually due to a spinal deformity, bone spurs, or osteoarthritis.
While hemilaminectomy may be less invasive, both procedures can be performed using minimally invasive techniques. The most important thing is to receive the correct care for any condition. If the patient is unsure about the decision, they should not hesitate to ask questions. NU-Spine’s Dr. Branko Skovrlj is happy to discuss treatments and help patients understand his recommendations.
Find Minimally Invasive Spine Treatments Near You in New Jersey
Transform your life with a touch of care at NU-Spine: The Minimally Invasive Spine Surgery Institute. Experience the cutting edge in minimally invasive spine treatments like thoracic hemilaminectomy and thoracic laminectomy. Don’t wait for relief – take the first step toward a pain-free future. Contact us today to schedule your first appointment at one of our locations near you in New Jersey.