Microsurgical Cervical Laminoplasty

Microsurgical cervical laminoplasty is a minimally invasive form of surgery that aims to decompress the cervical spinal cord while maintaining the integrity of the spinal column’s structures. No bone is removed or fused.; instead, the bone is reshaped to relieve pressure on the spinal cord. When instrumentation is used, the implants are oriented in a manner that does not sacrifice the option of the cervical spine.

This procedure is typically indicated for patients with symptomatic cervical spinal stenosis that may be caused by various conditions such as:

• Spondylosis (degenerative arthritis of the spine)
• Ossification of the posterior longitudinal ligament (OPLL), a condition where ligament calcification causes spinal canal narrowing
• Congenital stenosis (a narrow spinal canal present from birth)
• Degenerative changes leading to spinal cord compression

In progressive symptoms, surgical intervention is recommended over waiting to see if nonsurgical management may be effective.

1. Laminoplasty preserves mobility because it does not involve spinal fusion. This is particularly advantageous for patients who wish to maintain a greater range of neck movement post-surgery. By preserving the spine’s natural structure and mechanics, laminoplasty can result in a more natural distribution of stresses along the spine, which might be beneficial in preserving the long-term health of the spinal column.
2. Fusion surgery can increase the stress on the vertebrae adjacent to the fused section, potentially leading to degeneration or other problems in those segments, a condition known as adjacent segment disease. By avoiding fusion, laminoplasty minimizes this risk, potentially resulting in better long-term spinal health.
3. Typically, laminoplasty involves a shorter initial recovery time compared to fusion. This can lead to an earlier return to daily activities.

Post-operative pain and soreness are typically present at the surgical site in the days and weeks following surgery. When nerves are compressed for any length, it causes numbness and tingling and affects function. The longer the spinal cord has been compressed, the longer it takes to restore function and eliminate symptoms, but in cases where the compression is left unaddressed, permanent loss of function may occur. Most patients experience significant relief from symptoms and functional restoration following microsurgical cervical laminoplasty.

Rehabilitation involves physical therapy to improve neck strength and flexibility, which is crucial for a successful recovery. Physical therapy usually starts with gentle exercises and gradually progresses to more strenuous activities as the patient’s condition improves. The duration of rehabilitation can vary, but following a regimen to maximize recovery potential is essential. Return to activity may be possible in 4-6 weeks. Complete Recovery can take eight to twelve weeks.

Microsurgical cervical laminoplasty is a valuable surgical technique for addressing multilevel cervical spinal stenosis while preserving the spinal column’s stability and motion. Dr. Hieu Ball is an expert in microsurgical spine procedures.