Cervical laminoplasty is a surgical procedure to remove pressure on the spinal cord in the neck, in the form of spinal stenosis, or narrowing of the spinal canal.
Laminoplasty is recommended for patients who have severe spinal cord compression causing:
- Pain in the arms
- Balance problems
- Difficulty using hands
Significant, long-term damage to the nerves from spinal compression may be permanent, so it is important to see a doctor immediately if such symptoms develop.
What to Expect
A laminoplasty may be performed by means of an incision in the back of the neck, also known as a posterior approach.
In this procedure, the patient will be lying face down on the operating table. The bone lying over the spinal cord (the lamina) is cut on either side, creating a hinge on one side, and a small opening on the other.
Manipulation of this bone takes pressure off the spinal cord, creating more space for the spinal cord.
The surgeon then uses a spacer made out of bone, metal, or plastic which is inserted to keep the spinal canal open—known as an “open door” laminoplasty, because the position of the bone resembles a door being held open by a doorstop.
Another technique, known as a “French door” laminoplasty, creates hinges on both sides of the lamina and an opening in the center, allowing the lamina to be opened by elevating both sides, resembling a French-style patio door.
The anterior approach, or an approach from the front, can also be used with a laminoplasty, or a combination of approaches. You surgeon will determine which approach is best for you.
This surgery has been used for over 35 years, and has a low rate of complications. The most common complaint from it is stiffness and post-operative pain in the neck.
Sometimes nerves can be “stunned” after this surgery, as they return to their normal location after the compression has been relieved.
This can cause a nerve palsy, which can cause pronounced weakness and pain in the shoulder, but this nerve palsy is nearly always temporary, and goes away without treatment.
Patients typically remain in the hospital for two to three days after the surgery.
A neck collar will be given to be worn for the next few weeks after surgery, to be removed upon approval of your physician, who may also prescribe physical therapy to strengthen the neck muscles after surgery.
Most patients report a pronounced recovery of nerve function within months of the laminoplasty.
As the spinal cord heals itself, this nerve function continues to improve over 6 to 18 months.