Cervical Laminoplasty

Cervical Laminoplasty

Laminoplasty relieves pressure on the spinal cord by reshaping and hinging open the bony roof of the spinal canal — without removing it and without fusing the spine.

Cervical myelopathy occurs when the spinal cord in the neck is compressed over several levels, often by degenerative changes, ossification of the posterior longitudinal ligament (OPLL), or congenital narrowing of the canal. Left untreated, that pressure can cause progressive hand clumsiness, gait imbalance, numbness, and weakness.

In a laminoplasty, the surgeon makes a small trough on one side of the lamina and a hinge on the other, then swings the lamina open like a door and secures it with small plates or spacers. The canal is widened and the spinal cord is decompressed, while the lamina itself is preserved.

How it differs from laminectomy and fusion

Because the bony arch is kept in place, laminoplasty maintains more of the neck’s natural stability and preserves motion at the treated levels. That makes it an alternative to a multilevel laminectomy with fusion for carefully selected patients — particularly those with compression across several levels who have preserved cervical alignment and little or no neck pain from arthritis.

What to expect

Laminoplasty is performed through a midline incision at the back of the neck under general anesthesia. Most patients stay in the hospital briefly and begin gentle range-of-motion and strengthening exercises soon after surgery. The goals are to halt the progression of myelopathy and, in many patients, to recover function that had been lost.

Whether laminoplasty, laminectomy with fusion, or an anterior approach is the better option depends on the number of levels involved, the alignment of the cervical spine, and each patient’s symptoms. Dr. Agarwal reviews imaging and examination findings with every patient to select the approach that decompresses the spinal cord with the least disruption necessary.