Laminectomy
Objective
In cases of spinal cord pressure (including prolapsed disc)
• The removal of one or more vertebral laminae
• To decompress the pressure.
Position
• Cervical sitting
• Lumbar throracic prone (or knee elbow).
Anesthesia
General.
Procedure
1. A midline incision used.
2. The wound is deepened.
3. Self-retaining retractors are placed, and fascia is incised.
4. The paraspinous muscles and periosteum are reflected.
5. Sponges are packed along the vertebrae.
6. A larger retractor is placed from exposure.
7. Small portions of the laminae overlying the herniated disc are removed with a Kerrison rongeur.
8. Small portions of the laminae overlying the herniated disc are removed to provide adequate exposure.
9. Nerve roots are retracted exposing the herniated disc.
10. The wound is irrigated.
11. The area is examined to ensure that all protruding disc has been removed.
12. The wound is closed in layers.
Instruments
• Laminectomy set
• Kerrison rongeurs and pituitary forceps tray
• Power drill, drill bits, cord
• Basin set
• Blades (3 or 4) No. 10, (1) No. 15
• Sterile, plastic adhesive drape
• Suction tubing
• Asepto or bulb syringes (2)
• Cottonoids
• Gell foam and thrombin
• Roller gauze 2"
• Bone wax
• Antibiotic irrigation.
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Any questions be sent to drmmkapur@gmail.com
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