Featured: Ligamentum Flavum The procedure of a<unk>  remains largely the same regardless of the instrument used, or the level of vertebrae operated on.<unk> es require general or spinal anesthesia and frequently require a hospital stay following the procedure—although the duration of the stay depends on the physical condition of the individual and their reason for having a<unk> . A<unk>  takes about 70–85 minutes depending on the type of procedure used. Unilateral<unk> es typically require less time because bone is removed from only one lamina, whereas bilateral<unk> es usually take more time because bone is removed from both laminae. The level of the vertebrae that the<unk>  is performed on and what instrument is used produce no significant differences in the length of the procedure. Both unilateral and bilateral<unk> es are performed in a shorter time period compared to a conventional laminectomy which takes over 100 minutes on average. During a<unk> , the individual lies on his or her stomach with the back facing up towards the physician. An initial incision is made down the middle of the back exposing the vertebrae on which the<unk>  will be performed. In this procedure, the spinous process and the ligaments of the vertebral column are kept intact, but the muscles adjacent to the vertebral column known as the paraspinous muscles (example: spinalis muscle) must be separated from the spinous process and vertebral arch. In a unilateral<unk> , these muscles are detached only from the side on which the<unk>  is being performed. During a bilateral<unk> , these muscles must be removed on both sides of the vertebrae. The ligaments connecting the lamina of upper and lower vertebrae, known as Ligamenta flava are often removed or remodeled in this procedure to adjust for the small amount of bone lost. Using either a microscope or an endoscope to have a visual of the procedure, a small surgical drill is used to remove a part of bone from one or both laminae of the vertebrae.<unk> es can be performed on multiple vertebrae during the same surgery; this is known as a multi-level<unk> . A slightly different, but commonly used procedure of<unk>  is the unilateral<unk>  for bilateral spinal decompression. This minimally invasive procedure is often used to treat patients with excessive pressure in the vertebral column that must be relieved. In this procedure, the same spinal ligaments are kept intact and the paraspinous muscles must still be detached. A unilateral<unk>  is performed on one lamina of a vertebra. This removal of bone from one lamina provides an opening into the spinal canal. Using a microscope or an endoscope to visualize the procedure, surgical tools are inserted through this opening into the spinal canal. The surgical tools are then navigated underneath the spinous process and across the spinal canal to reach the other lamina on the opposite side of the vertebra to perform a second<unk> . The incision for this procedure is smaller because doctors need only access one lamina yet can perform a bilateral<unk> —remove bone from both lamina of a single vertebra. The unilateral<unk>  with bilateral spinal decompression procedure was developed almost 20 years ago and is a common successful surgical treatment for lumbar spinal stenosis.
Laminotomy
Foraminotomy
Laminoplasty
Myofascial release
Spinal mobilization
Foraminoplasty
Symphysiotomy
Laminectomy