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Is it normal to have your lamina removed during a microdiscectomy?

BrihtwulfBBrihtwulf Posts: 69
edited 06/11/2012 - 8:51 AM in Back Surgery and Neck Surgery
Hey Everyone,

I have recently looked at some recent imaging of my back, and it appears that my lamina was removed during a microdiscectomy at the L5-S1 level. Now, I'm not sure if this is normally a part of a microdiscectomy, but I was never told about it and it was never explained to me that it would be removed. What I was told is that a small portion of the side of my vertebra would be removed/excised in order to fix the damaged portion of the disc.

I'm not sure if the lamina even has much significance in terms of stability, pain, etc., but ever since my first back surgery I have had a lot of problems. The main things being that after my surgery I lost my achilles reflexes completely, my right ankle and most of my right foot have no feeling/sensation, and I have a distinct sharp pain just to the right of my surgical site.

And when I had to have a fusion surgery a little over a year later, my new neurosurgeon described what he saw as "a lot of scar tissue with my nerves all tangled up"...

So, anyone else had similar problems or know anything about the whole "laminectomy" thing?


  • Oddly, I was surprised to read the post-op report and see they cut away the lamina. I guess in all the rush of my surgery (I was somewhat urgent), I didn't quite understand they had to cut some of the lamina to complete the procedure.

    However, yes, I believe it is normal. They remove some of the lamina typically on one side (the side of the herniation) to make sure they can clear out all the 'herniated' disc material.

    As for results, with any surgery scar tissue can form. From my understanding, it is partially why they want you to walk every couple of hours. It helps keep scar tissue from tethering back to the nerve. Scar tissue is a pesky creature. You can have a lot of it with no issues or you can have just a small amount in the wrong place that causes the same pain as the disc hernation. IT's quite a frustrating beast.

    As for the loss of reflex - are you sure you had it before the surgery? I lost mine before the surgery. I was also told that I probably wouldn't get it back. This frightened me b/c I was limping as a result. I was told not to worry. Turns out, I am no longer limping. I still don't have that reflex but my 'foot drop' has gone away. It took almost 6 months post the 2nd surgery to even be able to stand on the left tip toe without my foot falling. At about 8 months, I was able to push up on my bad foot.

    I have to run but I hope some of this helps. I have some insights on numbness too (though mine was before the surgery). Incision site pain takes some time to go away.
  • Well, not necessarily "normal", but it is unfortunately common.

    Here, watch this microdiscectomy animation showing one way to get at a herniation and the other way like you describe.


    In the first version, the collateral damage is greatly minimized, but the surgeon cannot look down into the body(spine) thru the incision to see the herniation with his own eyes.
    He must rely on a camera on the end of a scope. The cam/scope is not shown in the animation, but it is inserted into the foramin the same way as the grasping instrument seen in the animation. Flouroscopy is also employed, although some of the instruments are non-metallic.

    In the other version, there is a bunch of collateral damage, but the surgeon has direct access, both visually and physically to the herniation because he did remove a portion of the lamina. Afterward, the surgeon will sometimes try to fill in the void with fat from elsewhere in the patient's body, but scar tissue eventually takes over the void.

    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • I didn't have the loss of reflex and numbness in my foot before I had the discectomy. Ever since the day of that surgery, I have had no achilles reflex or feeling in my right heel and most of my foot. It hasn't gotten better, either over time or after my later fusion surgery at the same location.

    When I was being told how my surgery would take place, my wife and I were told that they would make a small incision in the side of my vertebra, and they would conduct the surgery through there, removing the damaged portion of the ruptured disc. However, I am not sure if they just made a "small hole" in my vertebra or removed a large section of it.

    Of course, I've had a fusion surgery since then and I'm not sure exactly where I have my post-discectomy imaging right now (but I know I have it somewhere). I don't even know if my 5th lumbar vertebra still has the spinous process (is that right, right "fin") anymore.

    It just seems like doctors can get away with doing whatever they want and having whatever outcome regardless if they say that literally ANYTHING can be a "risk". So, I come away with loss of reflex, feeling in my foot, and a still-persistent severe pain... But I bet if I asked about what happened or why that happened they would just say, "those are the risks".


    EDIT: I didn't post dates above...
    Discectomy - 4/2008
    Fusion - 6/2009
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