If you’ve been diagnosed with spinal cord compression in your neck, a procedure called cervical laminoplasty may be an option for treating it. But as with any surgery, it’s important you have all the information you need before consenting to move forward. To help you feel confident you’re making the right decision, here’s what you should know about cervical laminoplasty.
Cervical laminoplasty surgery creates more room for your spinal cord.
The bundle of nerves that make up your spinal cord needs adequate room to travel from your brain down through your neck and back through a hollow opening called your spinal canal. Certain conditions can lead to a narrowing of your spinal canal, which, in turn, may put pressure on your spinal cord. Some of these conditions include:
- Degenerative changes in your spine
- Bone spurs
- Herniated discs
- Thickening of a ligament in your neck called ossification of the posterior longitudinal ligament (OPLL)
Cervical laminoplasty relieves the pressure placed on your spinal cord by increasing the amount of space within the spinal canal.
Certain symptoms indicate that you may need cervical laminoplasty.
The appearance of spinal cord compression on an imaging study such as an MRI isn’t necessarily an indication that you need surgery. Your doctor will also look for signs of myelopathy, the term used to describe an injury to your spinal cord. If your symptoms are mild, or if you don’t have any at all, you may be treated conservatively with things such as medications and physical therapy and continue to be observed by your doctor for any changes.
However, if more serious symptoms of cervical (neck) myelopathy are present, your doctor may suggest surgery to avoid long-lasting damage to your spinal cord. Myelopathy can affect your ability to function normally. Things to watch for include:
- Pain, stiffness, or numbness in your extremities
- Problems with using your hands
- Difficulty with balance and walking
- Problems with bladder or bowel control
Cervical laminoplasty can treat spinal cord compression at multiple levels of the neck.
Often, pressure on the spinal cord is found to occur at a few adjacent levels of your neck. A cervical laminoplasty can alleviate this pressure without impacting the ability to move your neck. As indicated by the name, a laminoplasty is performed on the part of your spine known as the lamina, which is a bony covering over the back of the spinal canal.
During the operation, your surgeon will make a small incision in the back of your neck. A hinge is made in the lamina to gently open and expand the space in your spinal canal. The procedure can be performed using an operating microscope to provide a magnified view, thus allowing your surgeon to work precisely and safely around your nerves in the area.
Some patients are better suited for cervical laminoplasty than others.
Though cervical laminoplasty can be effective for treating spinal cord compression and myelopathy, your surgeon should evaluate your specific case to determine if you are a good candidate. Cervical laminoplasty may be the right procedure if:
- You have pressure on your spinal cord at more than one level.
- You don’t have abnormal curvature in your spine.
- You don’t have instability in your spine.
- You don’t have extreme neck pain.
If cervical laminoplasty isn’t the best option for you, don’t despair. There are other procedures to consider. For example, your surgeon may suggest an anterior cervical discectomy and fusion (ACDF) procedure as an alternative.
Full recovery from cervical laminoplasty may take some time.
It’s normal to experience some neck pain immediately after surgery. However, you’ll be provided with a post-operative pain management plan to keep you as comfortable as possible during those first several days.
You may choose to wear a neck brace for comfort for a short time. You’ll be advised as to how and when you can resume activity from driving to exercising. Physical therapy may also be recommended to help strengthen your neck.
The good news is that prior injury to your spinal cord or spinal nerves will generally resolve. You should notice your symptoms improving over the next several months as your spinal cord and nerves repair themselves.
If you have further questions about cervical laminopathy, schedule an appointment with a board-certified spine surgeon. The expertise of a spine specialist can provide you with invaluable information when it comes to making treatment decisions.
About the author
Richard Kim, M.D. Born and raised in Southern California, Dr. Richard Kim earned his undergraduate degree in biochemistry from University of California, Riverside. This followed with a Master of Science in biochemistry and neurophysiology. He then earned his medical degree from St. Louis University School of Medicine in Missouri, graduating Magna Cum Laude. Read more articles by Richard Kim, M.D..