Laminoplasty is a surgical procedure that is performed specifically on the cervical spine (the vertebrae of the neck). It is done to decompress or lessen pressure that is surrounding the nerve structures and the spinal canal. During a laminoplasty procedure, the lamina, which is a vertebrae bone that protects the spinal canal, is slightly propped open by creating a hinge on one while the other side is wedged open with a small metallic plate or a bone strut.
Laminoplasty is different from a laminotomy whereby for the latter a portion of the lamina is removed, while for the former (laminoplasty) it involves repositioning or reshaping the lamina.
Why a Laminoplasty is Performed
Laminoplasty can be performed on patients who have stenosis of the spina. Spinal stenosis occurs when the spinal canal narrows and puts pressure on the spinal cord and nerve roots. The spinal canal can narrow due to the degeneration of intervertebral discs and joints. The condition can also be caused by the thickening of the connecting ligaments or by the formation of bone spurs.
Narrowing of the spinal canal may place pressure on the nerve roots or spinal cord causing symptoms such as:
- Pain in the shoulders, arms and hands
- Feeling of weakness, numbness and tingling in the neck
- Pain in the neck
- Problems in bladder or bowel functions
Laminoplasty – The Procedure
Laminoplasty surgery is done under general anaesthesia. The surgeon makes an incision of about 3 – 4 inches long on the rear of the neck. The neck muscles and tissues are dissected so as to expose the lamina. The surgeon cuts a groove on one side of the cervical vertebrae creating a hinge. He/she the cuts all through the other side of the cervical vertebrae and cuts the tips of the spinous processes to create enough room for the bones to swing open like a door.
The surgeon then opens the rear of the vertebrae to take pressure off the spinal cord and nerve roots. Small wedges of bone are placed in the open gap and the bone door is closed by the surgeon with the wedges preventing it from closing completely allowing for root nerves and the spinal cord to stay comfortably.
The soft tissues and muscles are put back in their places by the surgeon, the wound is closed using sutures, and a bandage is applied over it.
During a laminoplasty, the surgeon may also perform a foraminotomy to depressurize the nerve roots. Foraminotomy is a surgical procedure that enlarges the holes through which the roots of the nerves exit the spinal cord (also called as the foramina).
What to expect after the surgery
Following the laminoplasty surgery, most patients are able to get out of bed within one or two hours. There will be some discomfort and limitation of motion for a few weeks, but medication will be prescribed to alleviate discomfort during the recovery period. Wearing a neck collar may be also recommended during the recovery period.
NOTE: Duration of the procedure, downtime, and recovery vary on a case by case basis
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