What Is Laminoplasty and What Does It Involve?

Laminoplasty is used to decompress the upper part of your spinal cord that runs through your neck. Compression of this part of your spinal cord can lead to cervical myelopathy. Cervical myelopathy can cause symptoms such as:

• numbness or tingling in your limbs
• pain and stiffness in your neck
• limb weakness
• balance problems
• clumsiness and poor hand/finger coordination
• difficulty handling small objects such as coins and writing tools

Spinal cord compression can occur due to various conditions such as:

• arthritis
• bone spurs
• fracture
• herniated disc
• general wear and tear

A doctor or healthcare professional may recommend laminoplasty if nonsurgical treatment options have failed to relieve your symptoms.

According to the authors of a study published in the Journal of Spine Surgery, an ideal candidate for a laminoplasty is a person who:

• has compression of the spinal cord caused by multiple vertebrae in their neck
• still has a natural curve of their spine
• has minimal pain around their neck

Laminoplasty isn’t recommended for people with moderate to severe cervical kyphosis, which is an overly rounded upper spine.

Before your surgery, it’s important to tell your surgeon about any medications or supplements you’re taking. Some medications such as aspirin can interfere with your blood’s ability to clot. Your surgeon may tell you to temporarily stop taking these medications.

A laminoplasty is performed in a hospital under general anesthesia, meaning you’ll be asleep during the procedure. You’ll likely need to stay in a hospital for at least a couple of days, so it’s important to bring anything you’ll need during that time.

You’ll be told to stop eating and drinking before your surgery. In most cases, you’ll need to stop eating at least 6 hours in advance and stop drinking at least 2 hours before your surgery.

Right before your procedure, you’ll need to have the hair shaved on the back of your head. You may also have electrodes placed on your body so your nerve activity can be monitored during the surgery. The placement of these electrodes is painless.

You’ll be given general anesthetic and possibly antibiotics through an intravenous (IV) line before your surgery begins. Once you’re unconscious, a breathing tube will be put down your throat to help you breathe during the operation. Your shoulders and head will be fixed into place, and you’ll be positioned on your stomach.

Your surgeon will likely explain what will happen during the surgery, but here’s a summary of what this procedure typically entails.

1. The surgeon will make an incision in the middle of your neck and use a special device to hold the skin, fat, and muscle away from the bone.
2. They’ll then make a groove in the lamina on one side of your spine with a special drill. This will create a hinge.
3. They’ll then cut all the way through the lamina on the other side of your vertebra with the drill.
4. Next, they’ll lift the side of your lamina with the complete cut and use the groove created on the other side as a hinge.
5. A metal plate will be attached with screws to hold the repositioned part of your vertebra in place.
6. You may have a drain placed to control bleeding. It’s usually removed the next day.
7. Once the procedure is complete, the surgeon will close your wounds with stitches or staples. A topical antibacterial powder called vancomycin may be applied to decrease the risk of infection.

The procedure usually takes about 2 hours, but in some instances, it may take longer.

The amount of time you spend in the hospital depends on several factors, such as your overall health, the extent of the procedure, and any possible complications. Usually, you’ll be able to go home about 1 to 3 days after your surgery.

You may feel a lot of neck pain immediately after the surgery, but this should improve over the next few months. You’ll likely be given a neck collar to prevent excess movement as you recover. As a result, you’ll have limited motion in your neck for several weeks.

During the recovery period, you’ll need to avoid strenuous exercise for about 6 weeks. While you’re recovering, you’ll also need to avoid excessive bending, lifting, or twisting.

Your doctor will give you a specific list of activities and movements to avoid while you’re healing from your surgery. Getting plenty of rest and eating a healthy diet can also help support your body’s natural healing process.

To ensure a proper recovery, it’s important to carefully follow all your doctor’s instructions.

Laminoplasty generally has a low risk of serious complications. Research suggests the overall rate of complications is similar to or possibly better than other myelopathy procedures.

Potential risks can include:

• chronic neck pain
• numbness or weakness
• spinal fluid leak
• excessive bleeding
• infection of the surgical site
• an allergic reaction to the anesthetic

Infection is reported in 5% to 8% of people who have this surgery. Up to 11% of people develop kyphosis, an increased curve of their cervical spine after the procedure.

In a 2022 review of studies, researchers found that laminoplasty can achieve better results than another surgical procedure called laminectomy for treating cervical myelopathy. But the researchers note that further high-quality studies are needed to confirm these findings.

Studies suggest that about 60% to 70% of people who have laminoplasty experience relief from their neurological symptoms. Surgical results can last for more than 10 years.

Factors that increase the chance of a favorable outcome include:

• your age
• neurological findings before the procedure
• the duration of your disease
• whether you’ve had any other injuries to your cervical spine

Several surgical techniques have been developed to manage spinal cord compression.

Surgeons currently use two surgical approaches. One approach is to alleviate the compression from the anterior (front) of your spine. The other approach is to alleviate the compression from the posterior (back) of your spine.

Along with laminoplasty, other posterior procedures include:

• Laminoplasty with fusion: After a laminoplasty, the affected vertebrae are fused in place. You won’t be able to move these vertebrae after the surgery.
• Laminectomy: A laminectomy is the removal of all or part of your lamina. Compared with a laminectomy, a laminoplasty allows for more loading and better replication of natural movement.

Anterior procedures include:

• Anterior cervical discectomy and fusion (ACDF): ACDF is used to treat herniated discs and other neck conditions. It involves making an incision in the front of your neck to expose your spine, removing the damaged disc, and fusing your vertebrae above and below the removed disc.
• Cervical disc replacement: A cervical disc replacement involves removing a damaged disc and inserting a synthetic substitute.

Laminoplasty is a surgical procedure that involves relaxing a part of your vertebral bone called the lamina to relieve symptoms of spinal cord compression.

It’s generally considered a safe procedure but, as with most surgeries, comes with some risk. Research suggests that the risk is the same or lower than other surgeries used to treat spinal cord compression.

Your doctor can help you decide if laminoplasty is the best surgical option for you. They can also give you an idea of what to expect before, during, and after your procedure.