Laminoplasty

Laminoplasty or laminaplasty is a term that refers to a surgical procedure performed to relieve spinal cord and/or nerve root compression. To help you understand, let’s separate laminaplasty into two; lamina and plasty.

• Lamina - Located at the back of the spine, the lamina are thin bony plates between each facet joint in the cervical (neck), thoracic (mid back), and lumbar (low back) spine.  The laminar plates are part of the bony wall that covers and protects the spinal canal.  Within the spinal canal are the spinal cord and nerve rootlets.

• Plasty means to surgically repair

Your spinous processes are bones that project off the back of your spine. You can feel the end of most of your spinous processes by moving your hand up or down your spine.

Purpose

During laminaplasty, the lamina is cut in such a way that it opens like a door, and takes pressure (decompresses) off the spinal cord and nerve roots. Your neurosurgeon uses small pieces of bone or metal plate as a wedge to hold the lamina in position during healing.

Causes of spinal cord and/or nerve root compression includes:

• Cervical spinal stenosis
• Cervical herniated disc
• Cervical radiculopathy
• Degenerative disc disease
• Lumbar herniated disc
• Lumbar spinal stenosis
• Spondylosis
• Spondylolisthesis
• Tumor, infection (uncommon)

Before your procedure

Well in advance of your surgery day, your neurosurgeon explains how he performs your procedure.  During the discussion, you learn if your procedure can be performed as a minimally invasive spine surgery or open approach, and why.

Before surgery, you visit your primary care doctor or general practitioner to obtain a general health clearance. This means your doctor has carefully evaluated your health in terms of undergoing surgery.  Your assessment may include blood tests, x-rays or other imaging studies, as well as special tests for existing medical problems (i.e., diabetes, heart disease).

Of course, the potential benefits of the surgery are important to know, but so are the possible risks and complications. Your risks and complications may be different from those of another patient because you are unique. Your neurosurgeon takes that into serious consideration and thoughtfully explains potential risks to you, which may include infection, bleeding, reaction to anesthesia, and nerve damage.

About the procedure

Laminoplasty or laminaplasty is performed under general anesthesia. Throughout your procedure, the neurosurgeon and his surgical team are consistently kept current on your vital functions, including your central nervous system. Many different gauges, monitors, and equipment provide visual and audio feedback to the surgical team. Image guidance (real time x-ray; fluoroscopy) allows your neurosurgeon to see other views of the surgical field during (intra-operative) your procedure.

Basic surgical steps

• Your neurosurgeon creates a hinge by scoring one side of the vertebrae and then cutting completely through the opposite side
• The tips of the spinous processes are removed to allow the door to open
• Bone and/or soft tissue compressing the spinal cord and/or nerve roots is removed
• Your neurosurgeon wedges the door open using small pieces of bone or a special type of metal plate. The bone or plate holds the lamina in position during healing
• Intra-operative imaging (x-ray) confirms the wedge is properly positioned

After surgery

You are moved from the operating room into the recovery area. Here, the nurses and medical staff closely monitor your vital signs with attention to managing post-operative pain. You should expect some discomfort. You may have pain at the incision site, occasional neck or back muscle spasms, or other symptoms. When you wake up, you may be wearing either a cervical or lumbar brace-depending on whether you had neck or back surgery.

Post-operative care

Your surgery is over, but now your recovery starts! If you do not understand your post-surgical instructions or a problem develops, please call us-we are here to help you.

Conventional post-spine surgery instructions

• Schedule your post-operative appointment call (281) 446-3876
• Wear your brace as instructed
• Keep your incision dry and clean
• You may shower, but keep your incision covered and dry
• Rest; you will fatigue easily while your body heals
• Do not take a tub bath, go swimming, or sit in a hot tub or pool
• Begin physical therapy and/or exercise as instructed
• Take medications as prescribed
• Do not lift or carry anything heavier than a shoe
• Short periods of walking are encouraged
• Do not drive until cleared by your neurosurgeon
• Avoid riding in a car; short distances are permitted
• Do not smoke or use tobacco
• Eat well, your body needs nutritious food to heal

Call your neurosurgeon’s office (281) 446-3876

• Fever 101 degrees Fahrenheit or higher
• Redness and/or swelling around the incision site expands
• Change in the amount, odor or appearance of the incision drainage
• Incision pain increases
• Bowel or bladder dysfunction develops
• Genital area numbness develops

Next steps

We hope this information about laminoplasty and laminaplasty has answered your immediate questions. Remember, your doctor is your most valuable source to answer your questions about symptoms and your healthcare.