Atlas of Full-Endoscopic Spine Surgery by Hofstetter Christoph P.; Ruetten Sebastian; Zhou Yu'e

Author:Hofstetter, Christoph P.; Ruetten, Sebastian; Zhou, Yu'e
Language: eng
Format: epub
Publisher: Thieme Medical Publishers, Incorporated
Published: 2020-01-15T00:00:00+00:00

13.5 Laminotomy

Using a diamond or side-cutting burr, a laminotomy is initiated along the inferior aspect of the lamina along the insertion of the yellow ligament. The base of the spinous process is undercut along the insertion of the yellow ligament (▶ Fig. 13.3 b). Undercutting of the base of the spinous process is continued until the contralateral lamina becomes visible. Paying close attention to the transition of cancellous bone found in the base of the spinous process to cortical bone seen in the contralateral lamina helps recognize the transition to the contralateral side (▶ Fig. 13.3 c). Once the attachment of yellow ligament on the inside of the contralateral lamina is identified, the yellow ligament can be stripped off the ventral lamina using a sharp dissector. This maneuver reveals the angulation of the contralateral lamina and thus defines the direction of bony working corridor toward the contralateral foramen. Moreover, stripping off yellow ligament facilitates resection using the grasping forceps or Kerrison rongeur.

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