Cervical laminoplasty is a surgical procedure to remove pressure on the spinal cord in the neck that's caused by spinal stenosis. Stenosis is an advanced form of spinal degeneration that causes bony spurs to form on the vertebrae making the spinal canal narrower. 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 your physician immediately if such symptoms develop.
The surgeon will make an incision in the back (posterior laminoplasty) or front (anterior laminoplasty) of the neck. 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. This is known as an "open door" laminoplasty, because the position of the bone resembles a door being held open by a doorstop.
The surgeon may also use a "French door" laminoplasty, which creates hinges on both sides of the lamina and an opening in the center. This allows the lamina to be opened by elevating both sides, resembling a French-style patio door.
A combination of approaches can also be used. Your surgeon will determine which approach is best for you.
This surgery has been used since the 1970s 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. You may be given a neck collar wear for the next few weeks, to be removed upon approval of your physician. Your physician may also prescribe physical therapy to strengthen your 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.
Northwestern Memorial Hospital Regenstein Center for Neurological CareLavin Family Pavilion259 East Erie Street, Floor 19Chicago, Illinois 60611place