Laminoplasty

What is a laminoplasty?

A laminoplasty is a surgery to relieve pressure on your nerves and spinal cord. It opens up your spinal canal (the tube that holds your spinal cord) through your lamina. The lamina is a bone at the back part of the vertebra in your spine. A laminoplasty offers support and stabilization to your spine and prevents neurological complications like paralysis.

This surgery is most common on the bones in your neck or cervical spine in a procedure called a cervical laminoplasty.

What does a laminoplasty treat or manage?

Your healthcare provider might recommend a laminoplasty if your spinal cord needs more room. When you have a narrow spinal canal, your nerves and spinal cord don’t sit comfortably in your spine. It can feel crowded. This can cause pain and numbness in your neck and back and weakness in your arms and legs. You may feel off balance or unstable when walking. It can also affect your movement and how well you can regulate your bowels or bladder.

This procedure is most common if you have cervical spondylotic myelopathy or stenosis. Your surgeon might also recommend this procedure after a laminectomy if you’re at a high risk of failed back syndrome. This is persistent pain following surgery to treat the pain. Your surgeon can’t do a laminoplasty on a vertebral level with a previous laminectomy.

How common is a laminoplasty?

A laminoplasty is a common procedure, especially to manage conditions that affect your cervical spine (neck bones) like cervical myelopathy or stenosis.

How should I prepare for a laminoplasty?

You’ll meet with your surgeon before a laminoplasty procedure. They’ll perform an exam and learn more about your medical history. Your surgeon will order imaging tests to see your spine and plan for surgery. This might include:

• An X-ray.
• An MRI.
• A myelogram.

Let your surgeon know what medications or supplements you currently take. They may make changes to your medications by giving you a new prescription or changing the dosage of a prescription you already take. This can prevent complications from surgery. Don’t stop taking a medication unless your provider approves it.

Your provider may ask you to stop or cut back on using tobacco products as it can complicate how your body heals after surgery.

In addition, follow any specific instructions that your surgeon gives you. This could include what to wear and bring to the hospital on the day of your surgery and asking someone to drive you home from the hospital.

What happens during a laminoplasty?

On the day of your surgery, an anesthesiologist will give you general anesthesia. This will put you to sleep during the procedure so you won’t feel any pain.

Your surgeon will:

1. Make an incision (cut) in your skin above the affected lamina on the back of your neck. Move skin tissue, muscles and ligaments away from your spine.
2. Cut the lamina bone to open it. They’ll create a hinge or gap on one side of the lamina rather than completely removing the bone.
3. Place a bone graft or metal plates and screws to secure the new opening. This doesn’t fuse bones together. Each vertebral level gets its own plate to maintain your current mobility.
4. Move your muscles, ligaments and skin back into place. Close the incision.

Your surgeon may perform a foraminotomy after a laminoplasty. A foraminotomy decompresses nerve roots to relieve pain. In addition, your surgeon might place a drain at your incision site to regulate bleeding. They’ll remove it after 24 hours or when your care team finds it appropriate, depending on your situation.

What are the techniques used during a laminoplasty?

When planning for a laminoplasty, you may hear your surgeon discuss the specific technique they’ll use during the surgery. There are two techniques for a laminoplasty to open the lamina:

• Open door: Also known as a hinge, your surgeon will cut the lamina and open one side of the bone like a door. Metal plates and screws secure the lamina opening.
• French door: Your surgeon cuts the lamina down the middle. The bone opens out like a pair of double doors. Spacers and bone grafts secure this opening.

Your surgeon will choose the best technique for your situation.

How long does a laminoplasty take?

A laminoplasty surgery takes one to three hours to complete. Your surgeon can give you the best time estimate for your procedure.

What happens after a laminoplasty?

After surgery, you’ll stay in the hospital until your anesthetic wears off and your care team clears you to go home. You might need to stay overnight or for a couple of days in the hospital.

Your care team will give you medications to help you manage pain and discomfort. They’ll also explain how you can take care of yourself and your surgical site when you go home. In some instances, a cervical collar will help you during the recovery period. Ask your post-operative surgeon about their post-operative protocol.

You should treat your surgical site like an injury. Get plenty of rest and don’t participate in strenuous activities until your healthcare provider clears you to do them. Even household activities will be challenging for the first few days after surgery. It might help to have someone help you around the house until you’re well enough to safely get around on your own.

You’ll meet with your surgeon a few weeks after the surgery so they can review how well you’re healing. Your surgeon may recommend you meet with a physical therapist following your surgery to strengthen your muscles.

What are the benefits of a laminoplasty?

A laminoplasty treats a compressed spinal cord and nerves. It can help manage symptoms like pain and numbness and aims to prevent future complications like paralysis. A laminoplasty also supports your spine so you can hold your head and body upright and move comfortably. In addition, it avoids a fusion of the spine, so it doesn’t limit your movement.

What is the success rate of a laminoplasty?

One study found that up to 70% of people who underwent a laminoplasty felt relief from their symptoms like pain and numbness for 10 years following surgery. The results of surgery vary based on:

• Your general health at the time of surgery.
• Your age.
• Your nervous system health.
• How long you experienced symptoms before the surgery.
• If you had preexisting spinal injuries.

What are the disadvantages of a laminoplasty?

Side effects of a laminoplasty may include:

• Bleeding.
• Surgical site infection.
• Pain or numbness.
• Nerve damage.
• Lack of bladder or bowel regulation.
• Spinal cord injury (weakness or paralysis).

Long-term complications are rare but possible. They may include:

• Loss of spinal alignment.
• Kyphosis.
• Recurrent stenosis.
• Lordosis.

How long does it take to recover from a laminoplasty?

It can take six to 12 weeks to recover completely from a laminoplasty. You should be able to participate in light activities (like walking) as soon as you’re comfortable, which will likely be a few days after surgery. It could take up to six weeks until you’re able to get back to strenuous activities (like running or lifting weights). Your healthcare provider may allow you to go back to work when you’re comfortable, which could be up to a few weeks. Follow your healthcare provider’s post-surgery instructions to feel better sooner.

When should I call my healthcare provider?

Contact your healthcare provider if you experience any concerning symptoms or complications like:

• Skin discoloration.
• Swelling.
• Severe or worsening pain.
• Fever.
• Difficulty breathing or swallowing.
• Dizziness.
• Bowel or bladder management issues.

Don’t hesitate to contact your healthcare provider if you have questions about your recovery.