What’s the difference between a laminotomy and a foraminotomy? I have spinal stenosis and the surgeon says these two procedures might be helpful with the back and leg pain I’m having.

The lamina is the portion of bone along the back of the vertebrae that helps form a circle of bone around the spinal cord. This circle of bone is called the vertebral arch.

During a laminotomy, the neurosurgeon removes part of the lamina of the vertebral arch. Taking this piece of bone out takes pressure off the spinal cord. Complete removal of the lamina is called a laminectomy. If the spinal (facet) joint next to the lamina is removed, it’s called a facetectomy.

The foramen is a small opening for the spinal nerve. Once the spinal nerve leaves the spinal cord, it travels down to this opening in the bone. It passes through and goes down the trunk and/or leg.

A foraminotomy involves making the foramen larger or removing any tissue inside or around the natural opening. Bone, disc, scar tissue, or enlarged ligaments can compress the spinal nerve as it exits the spinal foramen.

These procedures are usually done with an arthroscope. The surgeon makes the smallest incision possible. The scope is used to give the surgeon a view inside and around the foramen. There are many variations to the operation. The surgeon decides how much bone (or other tissue) to remove based on what he or she finds at the time of the procedure.