Laminoplasty Surgery In India
The spinal cord and nerve roots in the neck are surrounded and protected by the cervical vertebrae. These bones have an opening called the spinal canal through which the spinal cord passes. Ligaments and blood vessels are also present in the spinal canal. The nerve roots start at the spinal cord and pass through an opening between the vertebrae called the intervertebral foramen (or neural foramen). From there, they extend to other parts of the body.
Laminaplasty is a procedure intended to relieve pressure on the spinal cord while maintaining the stabilizing effects of the posterior elements of the vertebrae.
The laminaplasty procedure involves “hinging” one side of the posterior elements of the spine and cutting the other side to form a “door”. As seen in the illustrations here, the door is then opened and held in place with wedges.
What Is Cervical Laminoplasty?
Cervical laminoplasty is a surgical technique that removex pressure from the spinal cord in then neck. Pressure on the spinal cord can be due to various causes including degenerative changes, arthritis, bone spurs, disc herniations, OPLL, tumors, or fractures. Frequently this spinal cord pressure, called spinal stenosis, can occur at multiple levels of the cervical spine at the same time. If this pressure is severe enough, symptoms called myelopathy can develop. Laminoplasty may be an excellent option to remove the pressure, allow the spinal cord to heal, and reverse the symptoms.
Laminoplasty vs. Vertebral Laminectomy-The Difference
Though the end objective of both Laminoplasty and Vertebral Laminectomy is the same, i.e. to relieve pressure off the spinal canal, the two surgeries are different in terms of the amount of bone and muscle tissue that has to be removed, displaced, or dissected in the procedure.
What Can I Expect ?
The main complaint after this kind of surgery is pain in the back of the neck. This pain can be quite severe for several days after surgery, and it then gradually improves over several months. Occasionally, one of the nerves in the neck can be stunned after surgery because of the movement that occurs when the nerve moves back to its normal location after removal of the compression. This nerve “stunning” is called a nerve palsy. This palsy can cause significant weakness, especially in the shoulder, and pain in same region. Fortunately, this palsy is almost always temporary and gets better without any treatment. Overall, the results for a laminoplasty are very good, the surgery is very well tolerated, and serious complications are very rare.
Patients who undergo laminoplasty frequently have multiple levels of severe spinal cord compression leading to nerve problems possibly including pain in the arms, numbness, difficulty using their hands normally, and balance problems. These problems can be very debilitating prior to surgery, but fortunately laminoplasty provides excellent decompression of the injured spinal cord. After a laminoplasty, most patients have significant recovery of the nerve function within several months after surgery, if not sooner. This nerve function improves over the next 6 – 18 months as the spinal cord continues to heal itself. Many patients can have complete resolution of the pre-operative symptoms, although long-standing spinal cord compression can lead to permanent nerve damage that never fully recovers.
Various conditions, including those as common as degenerative disc disease, can cause compression on the spinal cord in the neck. This compression can lead to impaired spinal cord function, called myelopathy. Treatment of myelopathy involves removal of the compression from the spinal cord via surgery. Laminoplasty is one of the options available, and it provides an excellent option for treating even severe cases of spinal cord compression. If you think you may have any of these conditions, please see your NASS physician for evaluation.