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Understanding Cervical Laminoplasty

Your spinal cord and spinal nerves are responsible for “communicating” messages between your brain and the rest of your body. Your spinal cord runs through and is protected by small bones called vertebrae that make up your backbone, or spine. Your spinal nerves run through openings in-between the vertebrae and out to your muscles.

Certain medical conditions can make these openings smaller and put pressure on your spinal cord and nerves. This is called spinal stenosis. If symptoms become severe, surgery may be needed to relieve the pressure. A procedure known as cervical laminoplasty is one method of treating spinal cord compression in the neck.

What are the symptoms of spinal cord compression in the neck?

Some people with spinal cord compression may be asymptomatic, but in more significant cases of compression, symptoms can include:

  • Neck pain
  • Numbness or weakness in the extremities
  • Pain radiating to the extremities
  • Difficulty with hand-eye coordination
  • Difficulty walking

Though rare, in the most extreme cases, paralysis can result.

What causes spinal cord compression?

Most cases of spinal cord compression are caused by degenerative changes in the spine, often as the result of age and wear and tear over time. Herniated discs, arthritis, bone spurs, trauma, and tumors can all place pressure on the spinal cord and nerves. Sometimes, spinal cord stenosis is present from birth.

When is cervical laminoplasty warranted?

If you have spinal cord compression, but no related symptoms, you may just need to be observed over time. Mild cases may be treated with pain medication such as nonsteroidal anti-inflammatories, steroid injections, and physical therapy. These treatments are aimed at providing comfort, however, and do not actually relieve the compression.

When symptoms of myelopathy—meaning injury to the spinal cord due to severe compression—appear, surgery such as cervical laminoplasty may be recommended to decompress the spinal cord and prevent irreversible damage. Your surgeon will make this determination based on your medical history and physical examination, and may use imaging like X-rays and MRIs to assess the amount of compression.

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What happens during cervical laminoplasty?

While under anesthesia, a small incision is made in the back of your neck. Your surgeon then creates a door-like opening on top of the bone that covers the spinal cord, known as the lamina. One side of the lamina acts as a “hinge” while the other side is lifted open, creating more space and taking pressure off the spinal cord. A bone graft or special instrumentation is then placed in the opening to keep the “door” in an open position, functioning similar to a door stop for a traditional door.

Cervical laminoplasty can be performed on several levels of spinal cord compression if needed. Advantages of this procedure include the preservation of motion and stability in that area of the neck.

In some cases, cervical laminoplasty can be performed using minimally invasive techniques. Surgeons trained in this technique can use special equipment allowing for smaller incisions and less trauma to surrounding tissues.

What can be expected after cervical laminoplasty?

It’s normal to experience some pain following surgery, but you’ll be given advice on how to manage the pain with things like ice and medication. You may also wear a soft cervical collar to help support your neck.

You’ll have some activity restrictions for the first several weeks, though you’ll gradually increase activity with time. Your doctor will advise you on when you can safely drive and return to work.

Keep in mind that it can take several months for nerves that were damaged to recover. Be patient with the healing process as your spinal cord repairs itself, but let your doctor know if you have any concerns along the way.

Grant D. Shifflett, MD

About the author

Grant D. Shifflett, MD Dr. Grant D. Shifflett is a fellowship-trained orthopedic spine surgeon. Handpicked by Dr. Robert S. Bray Jr. to join DISC Sports & Spine Center, Dr. Shifflett specializes in the application of minimally invasive and microsurgical techniques to the entire spectrum of cervical, thoracic and lumbar spinal conditions, from the simple to the most complex. Whether treating a patient with chronic pain or an acute injury, his ultimate goal is to restore function and quality of life with minimal tissue disruption. Read more articles by Grant D. Shifflett, MD.

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