Laminoplasty

What is Laminoplasty?

If the spinal canal is narrowed, such as in the case of spinal stenosis, the spinal cord and the nerves can become pinched or compressed. This causes irritation, pain and can lead to other serious complications. A Laminoplasty is a surgical procedure that makes more room in the spinal canal for the nerves and the spinal cord. The laminae can be compared to double doors. In this procedure, the laminae are surgically split and then the doors are held open by sutures or other surgical methods.

A Laminoplasty is most often performed in the neck area or the cervical spine. It can successfully make a significantly enlarged space for the spinal cord and the nerves. For some patients, a Laminoplasty a good option to consider instead of spinal fusion.

Laminoplasty is a surgical procedure which involves the process of increasing the space available to relieve abnormal pressure on the spinal cord and its nerve roots. It is done by reconstruction of the laminar arch via a posterior approach. Laminoplasty is a motion preserving surgery, in which no fusion is performed and motion is not changed.

Laminoplasty Indications

Laminoplasty may be performed in several conditions like spinal stenosis, spinal tumors, and syringomyelia. It is the mainstay treatment of cervical stenosis due to ossification of the posterior longitudinal ligament. Patients with degenerative spinal stenosis due to Spondylotic Myelopathy also show benefit after spinal decompression with Laminoplasty. It is also a procedure used to access underlying spinal diseases like tumor or Syringomyelia (spinal cyst).

Contraindications of Laminoplasty

Laminoplasty is not recommended for patients with kyphotic deformity, instability of the affected segment, spinal pathologies like cervical disc disease or traumatic vertebral body fracture with canal compression. These types of spinal pathologies are best treated by an anterior approach.

Risks of Laminoplasty

Any spinal surgery has potential surgical risk involved. This should be discussed with the patient during his pre-operative appointment. Potential complications of Laminoplasty may include:

- Pain and numbness due to nerve manipulation

- Weakness or paralysis due to the spinal cord or nerve root damage

- Bowel or bladder incontinence

- Impotence

- Cerebrospinal fluid leak

- Bleeding or injury to major blood vessels

- Infections

- Persistent or recurrent pain

Laminoplasty Procedure

Laminoplasty is done under general anesthesia. The patient is positioned face down on a special surgical bed. It is performed through a small incision on the back of the spine. Once the surgeon has safely created a window to expose the spine, the lamina is carefully cut all the way through. This allows the vertebrae to open, creating more space in the spinal canal. This immediately relieves pressure on the spinal cord and nerve roots.

The spinal canal is then inspected and any bone spurs or debris are removed. The bone flap is propped open using small wedges or pieces of bone so that the enlarged spinal canal will remain in place. Screws and metal implants may sometimes be used to keep the space around the spinal cord open. A soft cervical collar may be used for a short period after the Laminoplasty if the surgical location is in the neck.

Post-Operative Care for Laminoplasty

Each patient heals differently following a Laminoplasty but most patients are sent home after one to two days following Laminoplasty. Patients will be asked to walk on postoperative day 1 and adequate physiotherapy is prescribed to improve neuromuscular function unless there are neurological deficits.

Though walking exercises are advised, it is recommended to avoid excessive bending, lifting or twisting for several weeks to avoid breaking the sutures before the wound heals completely. A 6-week healing period with immobilization using a rigid collar or brace is recommended, particularly for children and young adults, to allow healing of the repositioned bone material after a Laminoplasty.

Adults do not need a brace or collar, though they may be offered a soft collar for 1 to 4 weeks. Wound care is administered according to standard protocols. Postoperative pain control will be achieved using oral or intravenous analgesics. The final goal postoperatively is to regain the normal function of the gastrointestinal and the urinary systems.

Success Rate of Laminoplasty

The success rate of Laminoplasty is generally favorable. This may, however, vary depending on their pre-operative baseline functional level. Some patients may have some improvement in function after a Laminoplasty; however, the main goal of the procedure is to prevent the worsening of the neurologic function or paralysis and not to improve its function.

You might also like to review:
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Questions & Answers
Q:
What is the best way to treat permanent back and neck pain and stiffness?
A:

Here are some tips:

Neck Pain Tips: Sleep with a cervical pillow

Orthopedic or cervical pillows are made with special contours to support the space beneath the neck and head. They are also more concave for the head and provide more support to the neck.

Neck Pain Tips: Sleep on your back

The best position to lie to sleep is on your back. If you sleep on your stomach or on your side, make sure your pillow is not too thick. It should raise your head no more than 4 to 6 inches. This will keep your neck and head from turning to either side.

Neck Pain Tips: Position your computer screen at eye level

While you are working at a computer, sit comfortably in your chair with your computer in front of you. Close your eyes and then open them. When you open your eyes, you should see the middle of the computer screen. If your gaze is not in the middle of the screen, adjust the height of the screen using items like books.

To keep your head from gradually drifting forward, take frequent breaks to stretch. Getting up to walk around at least once every half-hour is one of the best neck pain tips.

Neck Pain Tips: Use a telephone headset

Never hold a phone between your shoulder and your ear. Use a headset or other hands-free system to talk on the phone and avoid abusing your neck and spine.

Neck Pain Tips: Exercise your neck muscles

One of the best neck pain tips is using the chin tuck. You can do this often throughout the day. In addition to helping strengthen the muscles that hold the head in alignment over the shoulders, it also helps strengthen the scalene and sub-occipital muscles.

Read more tips here: Neck Pain Tips: Sleeping, Posture, Exercising, Hydration & Prevention

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Temed Holdings
4 answers
Q:
What is the best treatment for neck pain and shoulder Pain?
A:

One of the best treatment for neck pain and shoulder pain is exercises:

Neck Pain Exercises: Neck Extension

  1. To begin this neck pain exercise, sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place the palm of your hand on the back of your neck, at the base of your head
  4. Apply slight forward pressure with your hand, while resisting the forward motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax
  6. Repeat the neck pain exercises 5-10 times

Neck pain exercises: Side bend

  1. Sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place your left hand, palm down, on the left side of your head (around your ear)
  4. Slightly push your head to the right side with your hand, while resisting the sideways motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax.
  6. Repeat 5-10 times
  7. Repeat the neck pain exercises with the other side.

Neck pain exercises: Neck flexion

  1. Sit up straight in a chair with your feet flat on the floor.
  2. Looking straight ahead, tuck your chin slightly (starting position)
  3. Place the tips of your fingers on your forehead
  4. Slightly push your head backward with your fingers, while resisting the backward motion of your neck and head
  5. Hold for a count of 5 and return to the starting position and relax.
  6. Repeat the neck pain exercises 5-10 times

More exercises here: Neck Pain Exercises

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Temed Holdings
4 answers
Q:
How do I reduce the shoulder and neck pain?
A:

Here are some tips:

Neck Pain Tips: Sleep with a cervical pillow

Orthopedic or cervical pillows are made with special contours to support the space beneath the neck and head. They are also more concave for the head and provide more support to the neck.

Neck Pain Tips: Sleep on your back

The best position to lie to sleep is on your back. If you sleep on your stomach or on your side, make sure your pillow is not too thick. It should raise your head no more than 4 to 6 inches. This will keep your neck and head from turning to either side.

Neck Pain Tips: Position your computer screen at eye level

While you are working at a computer, sit comfortably in your chair with your computer in front of you. Close your eyes and then open them. When you open your eyes, you should see the middle of the computer screen. If your gaze is not in the middle of the screen, adjust the height of the screen using items like books.

To keep your head from gradually drifting forward, take frequent breaks to stretch. Getting up to walk around at least once every half-hour is one of the best neck pain tips.

Neck Pain Tips: Carry weight evenly

Many people make the mistake of carrying a heavy briefcase or their purse on their shoulder or on one side of their body. Doing this causes strain in the muscles and leads to pain.

Remove non-essentials from your briefcase or purse. Consider using a backpack to evenly distribute the weight across your shoulders. If you choose to carry a purse or backpack, keep your shoulders level while carrying it.

Neck Pain Tips: Maintain a proper posture

The most common posture contributing to neck pain is the “head-and-shoulders-forward” posture. In this position, the neck slopes forward, putting the head in front of the shoulders.

In this position, the head pulls the upper back forward also in a slumped position. This places a strain on the entire spinal column.

More tips here: Neck Pain Tips: Sleeping, Posture, Exercising, Hydration & Prevention

Read more
Temed Holdings
4 answers