Laminoplasty

Laminoplasty is indicated in cases where the spinal cord or nerve roots are compressed, leading to neurologic symptoms. Most commonly, the ideal patient has multiple areas of nerve compression, a spine that has a preserved or mostly preserved “ reverse arch” called lordosis, and does not have any condition such as severe arthritis or instability where fusion would otherwise be required. Common conditions that warrant laminoplasty include:

1. Cervical Myelopathy: Myelopathy is a spinal cord injury that occurs when the spinal cord is compressed causing nerve damage and dysfunction. It is caused by spinal cord compression due to degenerative changes such as herniated discs, osteophyte formation, or thickened ligaments.
2. Spinal Stenosis: A narrowing of the spinal canal, often due to age-related changes or conditions such as spondylosis.
3. Ossification of the Posterior Longitudinal Ligament (OPLL): A condition where ligaments in the spinal canal thicken and calcify, causing significant compression of the spinal cord.
4. Congenital Spinal Canal Narrowing: Some individuals are born with smaller spinal canals, increasing their risk for cord compression as they age.

The primary goal of laminoplasty is to relieve spinal cord and nerve root compression, which can manifest as:

• Weakness or numbness in the arms, legs, or hands
• Loss of fine motor skills
• Difficulty walking or balancing
• Tingling or burning sensations
• Severe neck pain
• Incontinence or bowel dysfunction in advanced cases

By decompressing the spinal cord, laminoplasty aims to stop the progression of these symptoms and, in some cases, improve neurological function.

During the procedure, Dr. Colman creates more space within the spinal canal by reshaping the lamina, the bony structure at the back of each vertebra. This is achieved by cutting the lamina fully on one side and partially on the other to create a “hinged door” that is opened and secured in position using small plates, screws, or bone grafts. This results in a much larger, expanded spinal canal. The most common techniques are the “open-door” and “French-door” laminoplasty, both designed to decompress the spinal cord while preserving the lamina and avoiding spinal fusion. The procedure is performed under general anesthesia and typically takes 1-2 hours, depending on the extent of the spinal cord compression. Laminoplasty is considered a motion-preserving surgery, as it maintains spinal stability and avoids the need for fusion in most cases. Laminoplasty is often performed on multiple vertebrae to address widespread compression and is usually paired with imaging guidance to ensure precision.

Recovery from a laminoplasty typically involves a hospital stay of one to three days, during which patients are monitored for pain, neurological improvement, and any potential complications. Pain and stiffness are common initially and are managed with medications and early physical therapy. Patients may be advised to wear a cervical collar temporarily to support the neck during the healing process.

Gradual improvements in symptoms such as pain and tingling are usually noticeable within days to weeks, though motor function and balance may take longer to recover. A tailored rehabilitation program, including stretching, strengthening exercises, and posture training, helps restore mobility and muscle strength over several months.

While many patients experience significant symptom relief, the full recovery process may vary depending on the severity of the initial condition and individual health factors.  A full recovery typically takes 6-12 weeks, with most patients able to return to light activities within a few days after surgery and gradually progress to more strenuous activities.