Treatment Options

  •  
  •  
  •  
  •  

Cervical Laminoplasty

Cervical laminoplasty is a surgical procedure intended to relieve pressure on the spinal cord. This is called spinal stenosis and can occur at several levels. Patients who typically have a laminoplasty have signs or symptoms of myelopathy, a condition that can result in weakness, pain, numbness in the arms along with difficulty with coordination of the hands, balance difficulties, gait disturbance, bowel and bladder dysfunction.

INDICATIONS FOR CERVICAL LAMINOPLASTY

Cervical laminoplasty is an option for patients who have signs or symptoms of myelopathy and have spinal cord compression at several levels throughout their cervical spine. The goal of a laminoplasty is to relieve pressure on the spinal cord and to hopefully prevent further progression of the patient’s symptoms.

LAMINOPLASTY  PROCEDURE

Procedure is done under general anesthesia and with the patient on his or her stomach. An incision is made in the back of the neck, and the spine is accessed through this incision. In this procedure bone is typically not removed. The bones are typically cut all the way through on one side and partially on the other side. This creates a hinge on the side that is partially cut. Bones are then hinged into an open position and kept in this open position with use of some small plates and screws. This alleviates pressure on the spinal cord and allows the spinal cord to move away from any structures that were pressing on it. Then blood flow to the spinal cord is improved.

POSTOPERATIVE COURSE

Most patients are typically up and walking the day after surgery. The most common complaint after cervical laminoplasty procedure is pain in the back of the neck. This can be quite significant for several days after the surgery but can be controlled with pain medications and muscle relaxers. Typically, patients are in the hospital for three to four days after the procedure and a cervical collar is used for several weeks.

RISKS

As with any surgical procedure there are inherent risks. These include risks of anesthesia, infection, nerve damage, bleeding, blood clots, bowel and bladder dysfunction. One of the risks known to laminoplasty is postoperative nerve palsy. This occurs as a result of spinal cord moving back into its normal position after removal of the compression. This can cause occasional stretch on the nerve roots coming off the spinal cord and result in significant weakness, particularly in the shoulder. This is called a nerve palsy which is temporary and usually will get better without any further surgical treatment. It is not uncommon for patients to have some residual symptoms in their arms and/or numbness in their hands and fingers, depending on the severity of the cord compression and the length of time of their symptoms prior to surgery. These are factors that can effect recovery. The spinal cord and nerves can continue to heal for up to 18 months after surgery.

Blue Distinction Center for Spine Surgery