Laminoplasty is a surgical procedure carried out usually in the vertebrae of the neck region to decompress the spinal cord in case of narrowing of the spinal canal in this region. The procedure is usually performed in the neck region but can also be performed in the thoracic (mid back region) or the lumbar region(low back region).It is also called “Open Door Laminoplasty” as the back of the vertebrae is made to swing open like a door (hinged at one end and open at the other end).
Laminoplasty aims at decompressing the spinal cord and the spinal nerves, by hinging open the vertebrae posteriorly. The lamina (flat arch on the backside of the vertebral body) is cut open on one side and grooved on the other side to keep it hinged to the main body of the vertebra. This creates more room for the spinal cord and nerves. Any compressing structure like a herniated or fragmented disc, or bony spurs, thickened ligament etc are also removed in this procedure. The advantage of this procedure is that the stability of the spine is maintained as the amount of bone and muscle tissue that is removed is very less, and any fusion surgery of the spine is avoided.
When is Laminectomy recommended?
Laminectomy is recommended when one or more of the following symptoms and disorders that affect the lower back are seen in the body:
- Ankylosing spondylitis
- Degenerative disc disease
- Herniated disc
- Spinal stenosis
- Spondylosis (also known as spinal osteoarthritis)
How is Laminoplasty done?
A laminoplasty is performed via an incision in the back of the neck which is called a posterior approach. During surgery, the patient lies on the back under anesthesia.
Specialized monitoring devices are used to check the spinal cord during the surgery to ensure that there is no damage to the spinal cord during the surgery. The bone overlying the spinal cord (the “lamina”) is partially cut on both the right and left sides. This creates a hinge on one side of the lamina and a small opening on the other side. The lamina is then moved into the “open” position by elevating the lamina on the open side, which increases the space available for the spinal cord and takes the pressure off of it.
The spinal cord can move away from whatever was compressing it including disc herniations or bone spurs and the spinal fluid can then flow around the spinal cord more normally. A spacer made out of bone, metal, or plastic, is usually inserted to hold the spinal canal open. The final position resembles an open door being help open with a door stop, and many surgeons refer to this technique as an “open-door” laminoplasty
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