Name of the Procedure:

Laminoplasty, Cervical with Decompression of the Spinal Cord, 2 or More Vertebral Segments; with Reconstruction of the Posterior Bony Elements (Including the Application of Bridging Bone Graft and Non-Segmental Fixation Devices [e.g., Wire, Suture, Mini-Plate])

Summary

Laminoplasty is a surgical procedure performed on the neck portion of the spine (cervical spine) to relieve pressure on the spinal cord. It involves expanding the space within the spinal canal and stabilizing the spine using bone grafts and fixation devices.

Purpose

Laminoplasty is typically performed to treat conditions that cause spinal cord compression such as cervical stenosis, herniated discs, or tumors. The goal is to alleviate pain, numbness, and other symptoms by decompressing the spinal cord and stabilizing the spine.

Indications

• Significant neck pain, numbness, or weakness due to spinal cord compression
• Cervical stenosis
• Cervical herniated disc
• Cervical spinal tumors
• Myelopathy (spinal cord dysfunction)

Preparation

• Patients may need to fast for several hours before the procedure.
• Adjustments to current medications will be advised by the physician, particularly blood thinners.
• Pre-operative imaging studies (MRI, CT scans) to assess spinal anatomy.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made in the back of the neck.
3. Muscles are moved aside to expose the vertebrae.
4. The posterior bony elements (laminae) are cut and hinged to create more space for the spinal cord.
5. Bone grafts are placed and secured using fixation devices such as wires, sutures, or mini-plates to stabilize the expanded area.
6. The incision is closed, and the patient is taken to recovery.

Duration

The procedure typically takes 2 to 4 hours depending on the number of segments involved.

Setting

Laminoplasty is performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic or Neurosurgeon
• Anesthesiologist
• Surgical Nurses
• Surgical Technicians

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Spinal instability
• Chronic pain
• Limited range of motion
• Complications from anesthesia

Benefits

• Relief from pain and numbness caused by spinal cord compression
• Improved mobility and function
• Stabilized spine structure
• Reduced risk of further spinal cord damage

Recovery

• Initial hospital stay of 1-3 days
• Pain management with prescribed medications
• Physical therapy may be recommended
• Avoid heavy lifting and strenuous activity for several weeks
• Follow-up appointments to monitor healing and spine stability

Alternatives

• Conservative treatments (physical therapy, medications)
• Cervical laminectomy (removal of the lamina)
• Anterior cervical discectomy and fusion (ACDF)
• Each alternative has its own risks and benefits; for example, non-surgical options may be less invasive but less effective for severe cases.

Patient Experience

Patients might experience discomfort and pain around the incision, managed with medication. Some initial limitations in neck movement are expected. Physical therapy will help regain strength and mobility gradually. Full recovery can take several weeks to months.