Laminectomy defination anatomy at lumbar level approach layers dissected structures removed pt positioning and things to look prepare for the case to be operated today
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lumbar laminectomy surgical technique anatomy posterior approach
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The answer above covers everything needed for the case. Quick summary of the key points:
Definition — Removal of one or more laminae ± spinous process ± medial facets to decompress the spinal canal.
Anatomy encountered — Spinous process → lamina → pars interarticularis → facet joint → ligamentum flavum → epidural space → thecal sac → nerve roots.
Approach — Straight midline posterior incision, thoracolumbar fascia opened, paraspinal muscles subperiosteally stripped off the spinous processes bilaterally.
Structures removed — Supraspinous + interspinous ligaments, spinous process, bilateral laminae (pedicle-to-pedicle), ligamentum flavum, medial facets (as needed).
Positioning — Prone on Wilson frame or Jackson table; abdomen free, arms < 90° abduction, eyes protected, genitalia/breasts free of compression.
For today's case:
- Confirm MRI level, fluoroscopy on standby, WHO timeout
- Bloods: group & screen for 1–2 levels
- Antibiotics within 60 min of incision
- Pedicle screw set on standby (in case instability found)
- IONM team if multi-level or deformity
- Flag high BMI, prior surgery, anticoagulants — all affect your approach and blood loss
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