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Cervical Laminoplasty Surgery

Cervical Laminoplasty

Cervical Laminoplasty Surgery in Mukundapur, Kolkata

Cervical Laminoplasty is a non-fusion decompression surgery designed to treat cervical spondylotic myelopathy (CSM). It serves as an alternative to Cervical Laminectomy for managing cervical myelopathy. "Laminoplasty" refers to various surgical techniques that involve reconstructing the vertebral lamina after opening the spinal canal.

The primary goal is to relieve pressure on the spine and spinal nerves by creating more space for the spinal cord. The lamina, the rear section of the vertebral bone, acts as a roof over the spinal cord. This surgery involves creating hinges that allow the lamina to be lifted but not removed, a method often called "open door Laminoplasty" because it makes the back of the spine swing open like a door.

Laminoplasty is typically performed on the cervical spine (neck) but can also be applied to the thoracic or lumbar spine (middle or lower back), particularly in pediatric or young adult patients. This procedure offers the advantage of maintaining cervical spine stability and reducing the risk of postoperative kyphosis.

FAQ's

Cervical Laminoplasty is a specialist treatment used to relieve pressure on the spinal cord at the neck level (cervical spine) caused by a variety of factors such as:

  • Degenerative changes
  • Arthritis
  • Bone spurs
  • Disc herniations
  • Fractures

Cervical Laminoplasty is a technique that involves reshaping or repositioning vertebral bones to reduce pressure on the cervical spine's nerves. The vertebrae are the bones that make up the spinal column, which protects the spinal cord.

Laminoplasty varies from typical spinal surgery in two major ways: 

  • Bone Preservation: No bone is purposefully removed during Laminoplasty, in contrast to routine spinal operations where bone may be removed. As an alternative, the vertebral bones are moved or altered to make greater room inside the spinal canal.

  • Preserving Spine Flexibility: Laminoplasty excludes the need to fuse bones. This keeps the spine flexible and able to move as it naturally does, which is essential for keeping the spine functioning normally.

  • Surgical Techniques: Laminoplasty can be done in a number of ways, but they all aim to widen the spinal canal in order to reduce pressure on the spinal cord and preserve spinal stability.

 

Cervical laminoplasty is recommended for patients with severe narrowing of the spinal canal involving multiple levels while maintaining normal spine alignment. This procedure is minimally invasive and may be used to treat various conditions, including:

  • Herniated discs
  • Osteophytes (lumps made of bone that develop on the spine's bones or around joints)
  • Thickened or hardened spinal ligaments
  • Cervical spondylotic myelopathy (CSM)
  • Degenerative changes in the cervical spine (cervical spondylosis)
  • Spinal tumors
  • Narrowing of the spinal canal since birth (congenital stenosis)

Surgery is effective for patients who have not responded to more conservative treatment options such as physical therapy and medicines.

A Cervical Laminoplasty involves several phases:

  • Administering anaesthetic, situating the patient, executing the treatment, and securely moving the patient to the recovery room. General anaesthesia is used for Cervical Laminoplasty surgery to ensure the patient's comfort throughout the process. 

  • The anesthesiologist monitors the patient during your procedure to ensure that it is performed safely. 

  • Once the patient is asleep and comfortable, the neuromonitoring team inserts electrodes into the muscles of the patient's legs and arms, as well as the scalp, to monitor the spinal cord and nerve root health throughout the treatment.

  • The patient’s head is secured with a special clamp or device to maintain stability. The patient is then positioned prone (face down) on a well-padded operating table. The arms are gently placed alongside the body.

  • A small incision is made in the middle of the back of the neck, typically measuring about two to three inches, extending from near the base of the skull to the lower part of the neck.

  • The muscles and connective tissues are carefully separated from the bony spine to expose the lamina (the back part of the vertebral bones).

  • The surgeon creates a "hinge" on one side of the lamina and opens the opposite side, creating more space in the spinal canal. The lamina is then secured in this open position using small plates or other devices.

  • Once the decompression is complete, the muscles and connective tissues are returned to their original position, and the incision is closed with sutures or staples.

Possible side effects of Laminoplasty include: 

  • Pain
  • Numbness from nerve manipulation 
  • Damage to the spinal cord
  • Nerve roots can cause weakness and paralysis
  • Bowel/bladder incontinence or impotence
  • Cerebrospinal fluid leak
  • Bleeding
  • Surgical site infection
  • General anaesthetic complications 
  • Nerve injury

Long-term problems are uncommon, but they may include: 

  • Loss of spinal alignment
  • Kyphosis (forward curving of the spine)
  • Recurrent stenosis
  • Lordosis (abnormal inward curving of the spine)

Individuals must spend a few nights in the hospital before beginning their recovery at home. Your surgeon would suggest you wear a soft, foam collar for one to two weeks as support.

You will experience persistent muscle soreness in your neck for several weeks, although this will improve over time. Vigorous activity, such as high-impact exercise, will be restricted for the first few weeks but can be resumed after four or six weeks. This should be reviewed with your surgeon, who may have a customised procedure for you to follow.

During a cervical laminoplasty, patients are under general anaesthesia, ensuring they are unconscious and pain-free throughout the procedure. After surgery, patients may experience some discomfort or pain at the incision site and in the neck area. However, pain management techniques are typically employed to help alleviate any post-operative discomfort.

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