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Cervical Laminoplasty Surgery

What does “Cervial Laminoplasty” mean?

Here is the meaning of each word:

  1. Cervical: the area of the spine located in the neck
  2. Laminaplasty: to change the lamina bone in the back of the spine

Altogether, “Cervical Laminaplasty” means to perform a surgery in the back of the neck to change the lamina bone.

What is a Cervical Laminoplasty surgery?

This surgery is done from the back of the neck. Instead of removing the lamina bone on the back of the spine, the lamina is “opened” like a door and then secured in the “open” position with bone and titanium screws and plates. Unlike in a Cervical Laminectomy, where the lamina bone is removed, a Cervical Laminaplasty keeps the Lamina in place.

Why is a Cervical Laminoplasty done?

It is done for cervical spinal stenosis where the spinal cord is under compression. When the lamina is “opened”, the compression of the spinal cord can be relieved.

How is a Cervical Laminoplasty surgery done?

Here are some of the steps of how this surgery is done:

  1. An intravenous catheter is placed and antibiotics are given before surgery.
  2. This surgery is performed in an Operating Room.
  3. The patient is placed under General Anesthesia while lying on their back (supine)
  4. The patient is then carefully placed on their stomach (prone) on the operating table.
  5. The head and neck are carefully positioned to make the approach for surgery as good as possible.
  6. The back of the neck is now cleaned with a surgical antiseptic and plastic covers (drapes) are placed around the area where the surgery will take place.
  7. The surgeon then makes the initial cut (incision) in the center of the spine.
  8. The softer tissues (fat, fascia) are then divided with a cautery until the tips of the spinous processes (tips of the spine) are seen.
  9. The muscle attachments to the back of the vertebra are then carefully separated from the bone and the muscles pulled to the sides.
  10. X-Rays are taken to make sure the surgeon knows this is the correct level in the spine.
  11. The spinous processes are now removed.
  12. The lamina bones are now clearly visible.
  13. On one side of the lamina, a drill is used to cut all the way through the lamina bone, while on the other side, it is used to cut a trough into the bone. The trough does not go all the way through the bone.
  14. The lamina can now be opened like a door.
  15. The spinal cord and spinal nerves are seen and freed up.
  16. Small pieces of bone are placed into the “open door” and secured with small plates and screws.
  17. The main part of the surgery is now complete. Additional X-Rays are often taken throughout. A surgical drainage tube is sometimes used.
  18. The retractors are removed and the muscles allowed to fall back over the area where the surgery took place.
  19. The muscles are usually stitched (sutured) back together.
  20. The skin is closed, often with small surgical staples.
  21. A bandage (dressing) is placed over the wound.
  22. Often, a hard brace is put on the neck to protect the area from movement.
  23. The patients is carefully rolled back on their back (supine) and awoken from Anesthesia.
  24. The patient is then brought to the Recovery Room.
  25. Often more X-Rays are taken there.

How long does a Cervical Laminoplasty surgery take?

This surgery can take about 2-4 hours to complete depending on how many spinal levels the operation involves.

What is the recovery from a Cervical Laminoplasty surgery like?

  1. The patient is admitted to the hospital for 1-3 days or more.
  2. A neck brace will often stay in place for much of the time in the hospital and often for 4-6 weeks or more after discharge.
  3. The surgeon will restrict the amount of motion in the neck. Typically, the movement in the neck is very limited at least for the initial few weeks.
  4. The patient is often discouraged from taking non-steroid anti-inflammatory medications which could interfere with the fusion.
  5. The patient is discouraged from smoking since it interferes with the fusion.
  6. The surgeon will evaluate the patient and take more X-Rays within a few weeks after surgery.
  7. The restrictions on movement are slowly lifted over time.
  8. The symptoms (pain, numbness, weakness) from the spinal stenosis may take weeks to months to reach the maximum level of improvement as the spinal nerves and spinal cord heal. Some of the symptoms from long-term spinal cord compression may remain.

What type of benefit can patients gain from a Cervical Laminoplasty surgery?

The main benefit is that the compression of the spinal cord and spinal nerves is now relieved. This can relieve symptoms of numbness, tingling and weakness in the legs.

Bowel, bladder and gait problems can be improved.

Depending on how long the spinal cord or nerves were compressed for and how severe the compression was, the recovery can be complete or partial.