- Are you ready?
- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together, we are the most famous
physical therapists on the Internet.
- Well, in our opinion, of course, Bob.
- All right, Brad, you have a subject you'd like to talk
- About today?
- Yeah. I'd like to talk about the term laminectomy
or the procedure laminectomy.
that if you have a back problem
and the doctor, or the surgeon says,
I'm afraid you're gonna have to a laminectomy,
or they might say hemilaminotomy,
and you're just gonna sit there with a face like.
- What is that?
- Right. Or you're getting real scared because you're
thinking they're gonna cut your back in half. And you know.
- Right
- Who knows what's gonna happen.
But if you understand these terms, it's really not such,
It makes it much less scary.
- Exactly.
- And it's not such a big deal anymore.
- Right.
- So laminectomy, let's talk about that first.
- Sure.
- So we're gonna break that term into two parts.
- There's the lamina, and the ectomy.
Ectomy saying there is removal of the lamina,
and the lamina is part of your back.
So let's take a look, at what's his name? Ken?
- Napoleon.
- Bonaparte.
- Lets bring him closer here.
- Oh we lost a wheel Bob.
- Okay. Let's get a close up here.
- [Bob] Bonny, Can you See pretty well there?
- [Brad] Watch out Bob. There.
Okay.
So there is the vertebrae throughout your whole spine,
and each vertebra has the part
of it called the lamina.
- [Bob] Right.
- So we're gonna look at,
and typically it's gonna be done in the lumbar.
It could be up in the cervical.
- [Bob] Lumbar are the last five vertebrae of your back.
- Right.
- The lowest, the lowest five.
- Right.
- [Bob} If you don't count the Sacrum.
- And oftentimes it's done at L five.
One of these lower ones, but it could be any of 'em.
You'll be informed of that.
- [Bob] This is Is L five. This is L 4 3, 2 1.
- Right. So let's take one of these vertebra out.
Okay. This is my magic trick.
We're gonna take two of them out. Whoa.
- [Bob] There you go.
- [Brad] Okay, here we go.
Now we're gonna take a closer look at,
here We got L four, or L five and L four, and then
we're gonna take it apart even more.
Go ahead and pull that top vertebra off.
Now this represents your spinal cord
and your peripheral nerves coming out between each.
You always have peripherals nerves between each vertebra,
and by the way, that's typically why you're gonna have one
of these is one of these nerves is getting pinched.
- [Bob] it's getting pressure on it. Yeah
- [Brad] Yep, It's getting pinchment on it,
causing pain, et cetera, down the leg often times.
- [Bob] Why Don't you flip it up like this, Brad.
You can see here's a disc,
and see how that's bulging or herniating out.
That's pushing on the nerve there.
- [Brad] Right. So yeah, we can actually pull,
pull that disc off. We're really doing a nice job.
- [Bob] We're we're doing surgery.
- [Brad] Of dissecting yeah.
- [Bob] We're doing surgery ourselves.
- [Brad] There, We got the disc
with the representation of that herniation there.
But what they're gonna do is to get rid
of the pressure in this case.
- [Bob] Why don't you go way up there.
- [Brad] Yeah. Can you, instead of working on that disc
cause you may not have a bulging disc but we may have,
- [Camera person] it's kind of blurred.
Ooh, there you go.
- [Brad] Is that good?
Okay.
- [Bob] Yeah, I'd say flip it this way, Brad.
- [Brad] Okay.
- [Bob] There you go.
- [Brad] So we're looking down at the top of the vertebra.
Here's where the spinal cord goes.
Okay. And they're gonna go
and remove part of this bone here, which is lamina
and part of the transverse process typically.
And there's a ligament in
there called the posterior ligament.
Now any of these structures could be worked on.
It's one of those things you're gonna have to go
to the, you know, talk to your surgeon,
and hopefully they'll explain it in detail,
pull out a model and say
this is what we're gonna remove in your situation.
But here's the Lamina, is this section of bone right here.
And if we put it back together, so it all makes more sense.
We go to here. Whoops.
let me get that nerve where it belongs.
Okay. Now let's go back to here.
So then make it in reference to your back, go to here.
So when you look at it in here that lamina is here
or it's in here, they, they do a small little incision.
It's amazing how small those incisions are.
- [Bob] Right.
- [Brad] about an inch or two.
And they spread the tissues apart.
Then they get in there and they do their procedure
and they can usually do this in one day.
Sometimes they have to stay overnight.
It's gonna vary on your situation.
We're not gonna make any predictions on that
but you have to talk to your surgeon.
- [Bob] In my experience, Brad
people have laminectomies or laminotomies.
It's not as involved as if they've had
if they have to have fusion of the back, you know.
- Right.
- [Bob] when they have to start with bars in
- and, and hardware
- hardware. Yep.
- Come back here Bob, so they can see us.
- When they're just doing the going
in and removing a little bone, it's not nearly
as involved or the, the rehab is not nearly as
involved.
- Right, right.
- As is when you have to do that
and maybe do some fusion of the bag.
- Right. So, and actually a lot of times laminectomies
like this are in and out and they won't even
need surgery that pain down their leg will go away
quite right after surgery.
Sometimes they need rehab and et cetera, its always,
- You mean they won't need rehab.
You said they don't need surgery.
- Oh sorry. Thanks Bob.
- You. Yeah, you're right.
We often don't even see these people after, after
after they've had a laminectomy. So.
- And, and as far as the hemilaminotomy
now that's a different situation.
I don't think those are near as common.
- I've never seen one.
- Right. I haven't either.
You know, I had to look it up and it's the removal
of the mid portion of the laminate so it is actually
taking that laminate right out of there.
Again, get that cleared up with your doctor, your surgeon.
If you have that term thrown at you, like you did.
- were you gonna mention a study Brad?
- Nope.
- Oh, you're not.
I thought the Journal of Shoulder and Elbow?
- No, that's for our next video.
- Oh, stay tuned and subscribe
- You better believe it.