Cervical Laminaplasty

Overview

Cervical laminaplasty (also called laminoplasty) is an elegant, motion-preserving procedure for patients with cervical myelopathy — spinal cord compression caused by a congenitally narrow spinal canal, multi-level degenerative changes, or ossification of the posterior longitudinal ligament (OPLL). Rather than removing bone and fusing the spine, laminaplasty expands the spinal canal by creating a hinge on one side of the lamina and opening the other side like a door. Small plates or spacers hold the door open, giving the spinal cord significantly more room. Because the spine is not fused, patients retain most of their natural neck motion. Dr. Basques is one of the few surgeons in New England offering cervical laminaplasty as an alternative to multi-level ACDF or laminectomy with fusion.

How It Works

Under general anesthesia, the patient is positioned face-down. A midline incision is made in the back of the neck. The paraspinal muscles are gently elevated to expose the laminae (the bony roof of the spinal canal) at the affected levels. Using a high-speed burr, Dr. Basques creates a trough on one side of the lamina that goes all the way through the bone (the open side). On the other side, a shallower trough is created that only goes partway through the bone, creating a hinge. The lamina is then gently opened like a door, expanding the spinal canal and giving the spinal cord more room. Small titanium plates are secured to hold the door open permanently. The muscles are closed back over the hardware, and the skin is closed with sutures. The procedure typically takes 2–3 hours for 3–5 levels.

Benefits

Who Is a Candidate?

Ideal candidates have cervical myelopathy (spinal cord compression with symptoms like hand clumsiness, gait imbalance, or bowel/bladder changes) caused by multi-level stenosis, a congenitally narrow canal, or OPLL. Candidates should have preserved cervical lordosis (no significant kyphosis) and minimal neck pain. Patients who want to preserve motion and avoid a long fusion are strong candidates. Dr. Basques determines candidacy with MRI, X-rays (including flexion/extension views), and CT scans.

Recovery & Aftercare

Most patients stay in the hospital for 2–3 days. A soft collar is worn for 2–4 weeks for comfort and protection while the hinge heals. Light activities resume after 2 weeks. Return to desk work is typically 4–6 weeks. Physical therapy begins at 6 weeks to restore range of motion and strengthen neck muscles. Full recovery takes 3–6 months. The goal is to halt the progression of myelopathy and allow the spinal cord to recover — improvements in symptoms can continue for up to a year after surgery.

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