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Cervical laminoplasty Surgery - Know The Procedure & Cost!
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Definition- 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). Spinal stenosis is a condition where there is narrowing of the spinal canal and often the neural foramen that causes compression of the spinal cord and/or nerve roots. This narrowing is caused by numerous factors including bone spurs, degeneration of the intervertebral disks and facet joints, and thickening of the ligaments. Among the symptoms spinal stenosis can produce are pain and/or numbness in the arms, clumsiness of the hands, and gait disturbances. This procedure is used to relieve spinal cord compression in the cervical spine. Its most common use is in severe cases in which the spinal cord is compressed at multiple levels. However, instead of completely removing the lamina (bony roof), the lamina is hinged on one side and rotated away from the spinal cord. This procedure allows marked expansion of the spinal canal and relieves compression of the spinal cord. It also is a good alternative to an anterior cervical decompression and fusion. The laminoplasty is performed posteriorly and does not involve fusion of the spine. It allows for decompression of the spinal canal while maintaining good stability.
Procedure of Cervical laminoplasty-
laminoplasty opens the lamina to relieve symptoms by releasing pressure on the spinal cord and modifies the lamina so that there is still a protective covering at the back of the spinal cord. There is more than one method of performing laminoplasty. Your doctor will let you know which laminoplasty method is most appropriate for you.
One method of laminoplasty uses a complete incision on one side of the lamina and a partial incision on the other side to create a "hinged door."
Another method of laminoplasty is referred to as the "French Door Method." This surgery uses a complete incision through the middle of the lamina and partial incisions on each side to create two "doors" that open in the middle. The spinous process projections are removed to allow room for the doors to open. The opened door relieves pressure on the spinal cord and nerves. Pieces of bone or surgical hardware are placed to allow the "doors" to remain open, and at the same time, creates a protective roof that covers the back of the spinal cord. When the procedure is complete, the incision is closed and bandaged.
Advantages of Cervical laminoplasty-
1) Patients stay in the hospital for 24 hours, and generally do not need a cervical collar.
2) Most patients will notice immediate improvement of their symptoms.
3) Most patients discontinue pain medication and resume their regular activities within a few weeks.
4) For some people function returns following laminoplasty and allows them to resume their favorite activities.
5) For people with significant nerve damage, although function may not return, a laminoplasty can help keep their condition from progressing.
Precautions after Cervical laminoplasty-
1) Participating in physical therapy will help you gain neck strength and flexibility.
2) Physical therapists and occupational therapists work with patients and instruct them on proper techniques of getting in and out of bed and walking independently.
3) Patients are instructed to avoid bending and twisting of the neck in the acute postoperative period (first 4-6 weeks).
4) The wound area should remain covered with a gauze bandage secured in place with tape. The area should be kept clean and dry. The bandage should generally be changed every 1-2 days, especially after showering.
1) The results of laminoplasty surgery in the treatment of symptomatic, progressive, cervical spinal stenosis and myelopathy are generally good.
2) The surgery serves to improve pain and function and prevent further neurologic deterioration and paralysis.
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