Laminotomy and Laminoplasty
Laminotomy is neck surgery performed in the posterior spine to remove part of the middle of one lamina and the ligamentum flavum. It may be conducted through a traditional open technique or using tubular retractors and endoscopes in a minimally invasive technique. Laminoplasty is the partial cutting of the lamina in such a fashion that the lamina moves like a hinge thereby allowing spinal decompression whilst maintaining some stability and rigidity in the spine. These two procedures may be considered where a laminectomy is thought inappropriate or unnecessary. This type of situation may arise where a surgeon wishes to decompress the spine but is concerned that removal of the lamina may cause the patient’s spine to begin curving and become overly flexible with subsequent degenerative problems. Those who already have spinal curvature may be more likely to undergo either a laminotomy or a laminoplasty in preference to a laminectomy in order to reduce further risk of spinal curvature.
Laminotomy and laminoplasty are likely to provide neck pain relief and relief of radicular pain in cases of cervical spinal stenosis with myelopathy, cervical spondylitis, and possibly ankylosing spondylitis. Narrowing of the spinal canal, with resulting pressure on the cervical nerves and spinal cord can be caused by disc herniation, osteophyte growth, calcification of the ligamentum flavum, or as a result of trauma. The pain of a pinched neck nerve may be assisted by decompressing the implicated part of the spinal canal. If the stenosis is severe then a laminectomy with fusion may be considered in order to access other problematic areas such as a herniated disc or severe osteophyte growth and obstruction which cannot be reached through either laminotomy or laminoplasty.
How Neck Surgery Helps
Laminoplasty and laminotomy are advantageous in that they may reduce the risk of the spine tilting forward due to postoperative loss of stability. Unfortunately these minimally invasive procedures may make it difficult to assess the extent of decompression achieved as visual access to the spine and spinal cord are restricted. A laminectomy grants a large degree of access to the spine and its structures making it fairly easy to assess the level of surgical success and to operate on any bone spurs or problem discs. Advances in the technique of laminotomy and laminoplasty mean that herniated discs can now also be removed during these procedures.
Next read about: Considerations and Preparation for Laminotomy