Cervical Laminoplasty

What is it?

Cervical Laminoplasty is a surgical procedure designed to relieve pressure on the spinal cord in the neck region while maintaining spinal stability and motion. It is primarily used to treat cervical myelopathy caused by spinal canal stenosis, which can occur due to degenerative changes, congenital narrowing, or ossification of the posterior longitudinal ligament. Unlike laminectomy, which involves removing parts of the vertebrae, laminoplasty expands the spinal canal by partially cutting and hinging the laminae, which reduces the risk of postoperative instability and eliminates the need for spinal fusion.

Cervical laminoplasty offers several advantages over laminectomy, including preserved spinal stability and motion, which reduces the risk of postoperative deformity. Most patients experience significant improvements in myelopathic symptoms after the procedure, although neurological recovery may vary depending on the duration and severity of preoperative symptoms.

Postoperative management typically involves early mobilization and physical therapy, with the use of a cervical collar based on the surgeon’s assessment.

Procedure

The procedure involves a posterior approach to the cervical spine, which can be performed unilaterally or bilaterally, depending on the underlying pathology and surgeon preference. The goal is to create more space for the spinal cord while preserving the posterior elements’ integrity.

During the operation, neurophysiological monitoring is often used to ensure spinal cord safety. Precise osteotomy and careful handling of the spinal cord and nerve roots are crucial to prevent iatrogenic injury.