Laminoplasty

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)

 

Relevant Anatomy
The human spine is made up of 33 small bones called vertebrae stacked on top of another, with soft cushion like structures called the intervertebral discs between them. The verterbral column encloses the delicate spinal cord within its spinal canal. Any space occupying structure within the spinal canal will narrow the canal and compress on the spinal cord and the emerging nerves, resulting in symptoms like pain, numbness and tingling in the arms and hands, clumsiness of hands, disturbance in walking and loss of bowel and bladder control. 

 
                                
 
 
Objective of the procedure
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.

 
What type of patients need this surgery?
Any patient with the complaint of pain numbness and tingling in one or both upper extremities, and /or disturbance in walking, or loss of control in bowel and bladder for a considerable period of time despite conventional treatment like rest, physical therapy and medications are recommended for this type of procedure. 

 
How is the surgery performed?
This surgery is performed by sedating the patient under general anesthesia and making him lie on his stomach. The head is kept slightly bent with the help of Mayfield clamp to straighten the skin folds on the neck. A midline incision is made on the back of the neck corresponding to the affected spinal segment. The skin is cut open and the muscles are separated to view the involved vertebrae. The lamina are cut through their thickness longitudinally on one side and grooved on the other side to keep it hinged to the vertebral body. The posterior part of the vertebra is swung open like a door. Small wedges made of bone are placed in the opened space of the door. The door of the vertebrae swings shut, and the wedges stop it from closing all the way. The spinal cord and the nerve roots rest comfortably behind the door. Since this increases the space in the spinal canal, it decompresses the spinal cord with immediate relief of symptoms. Any presence of herniated disc, thickened ligament or facet joint and osteophytes are identified and removed.
 
    
 
Post Operative Recovery an Rehabilitation
The person is usually up and about on the same day after surgery and is discharged in one or two days later. The Physical therapist advises certain exercises of the neck to maintain the flexibility and strength of the neck muscles before the patient is discharged.  Certain ergonomics advice regarding neck movements is also given. The patient is able to return to his daily activities wearing a soft cervical collar within a few days. The collar is discarded after some time.

 
SpineNeuroSurgeryIndia.com affiliated Hospitals
Our Hospitals that undertake this procedure have a well equipped operation theatre with high standards of hygiene. They have all the specialized instruments like Mayfield tongs, rongeur etc required for the procedure. Our affiliate hospitals also have excellent diagnostic centers with CT, MRI, Digital X-ray facilities to support the efficient and dedicated staff comprising of highly qualified orthopedic or neurosurgeon, OT Technicians and nurses. We aim at providing the best medical care at the most affordable prices to our patients. 
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