What Type of Surgery Is Preferable for L5-S1: a Laminectomy or a Laminotomy?

Doctors generally prefer to treat an L5-S1 injury with a laminotomy because it requires a smaller surgical incision than a laminectomy, notes Oregon Health & Science University Spine Center. A laminotomy is also less damaging to surrounding muscle tissue.

Both laminotomies and laminectomies reduce the pressure on nerves and reduce pain associated with spinal stenosis and herniated discs, notes WebMD. This is done by removing part or all of the small, thin portion of the vertebrae known as the lamina.

During a laminotomy, the surgeon uses a microscope to view the affected nerve, explains Mayo Clinic. During a laminotomy, a small portion of the lamina is removed. Laminotomies are used to treat both spinal stenosis and herniated discs.

A laminectomy involves the removal of the majority of the lamina, notes OHSU SpineCenter. This type of surgery is only used on patients with severe nerve damage that cannot be fully viewed through the microscope used during a laminotomy. Depending on the severity of the injury, surrounding ligament tissue may also be removed. While laminectomies are used to treat both spinal stenosis and herniated discs, they are more often used to treat cases of spinal stenosis.

A laminectomy or laminotomy is generally the final treatment option, according to Mayo Clinic. Before surgery is considered, physical therapy and nerve blocks may be used to lessen pain.