Introduction

The cervical spine is composed of a series of small bones in your neck. Your spinal cord is located in an opening inside of the bones. The spinal cord and spinal nerves exchange information between your brain and body. Certain degenerative spine conditions can cause the opening in the spine to become smaller. When this happens, it can put pressure on the spinal cord and nerves, affecting the way they work and causing pain.

A cervical laminaplasty is a surgical procedure that is used to create a larger opening in the bone to relieve the pressure on the spinal cord and nerves. A laminaplasty can relieve symptoms to allow people to resume their favorite activities. For people with significant spinal cord or nerve damage, function may not return following laminaplasty, but the procedure stops their condition from progressing further.

Anatomy

Your spine is divided into regions defined by their curve and function. The cervical spine is located in your neck. Seven small bones called vertebrae align to make up the cervical spine.

The back part of each vertebra arches to form a roof-like cover, called the lamina. The spinous process is a thin piece of bone that projects from the back center of the lamina. The spinous process is commonly referred to as the “backbone,” which you can feel when you touch your spine. The spinous process is a place where muscles and ligaments attach to the spine.

An opening in the center of each vertebra forms the spinal canal. The spinal cord, nerves, and blood vessels travel through the protective spinal canal. Nerves exit the spine and exchange information with the brain about the shoulders, arms, and hands.

Causes

A cervical laminaplasty is a treatment option for certain degenerative spine conditions that put pressure on the spinal cord and spinal nerves. A laminaplasty surgically opens the lamina to provide more room at the back of the spinal canal, which takes pressure of the spinal cord and nerves. The lamina is reconstructed to create a new protective roof over the spinal cord.

Symptoms

Depending on the location of the affected vertebrae, degenerative spinal conditions that compress the spinal cord in the cervical spine can cause pain, tingling, or numbness at the neck that may spread to the shoulders and arms. You may experience impaired function, such as weakness or poor coordination. Degenerative spinal conditions can also cause headache.

Diagnosis

You doctor can diagnose degenerative diseases of the spine by examining you and viewing images of your spinal structures. Such imaging tests may include X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans. Your doctor will let you know if you are a candidate for laminaplasty.

Treatment

A laminaplasty is an inpatient surgical procedure. Laminaplasty opens the lamina to relieve symptoms by releasing pressure on the spinal cord and modifies the lamina so that there is still a protective covering at the back of the spinal cord. There is more than one method of performing laminaplasty. Your doctor will let you know which laminaplasty method is most appropriate for you. One method of laminaplasty uses a complete incision on one side of the lamina and a partial incision on the other side to create a “hinged door.”

Another method of laminaplasty is referred to as the “French Door Method.” This surgery uses a complete incision through the middle of the lamina and partial incisions on each side to create two “doors” that open in the middle. The spinous process projections are removed to allow room for the doors to open. The opened door relieves pressure on the spinal cord and nerves. Pieces of bone or surgical hardware are placed to allow the “doors” to remain open, and at the same time, creates a protective roof that covers the back of the spinal cord. When the procedure is complete, the incision is closed and bandaged.

People typically remain in the hospital for a few days following laminaplasty. Participating in physical therapy will help you gain neck strength and flexibility. Your symptoms may improve immediately or over time. For some people function returns following laminaplasty and allows them to resume their favorite activities. For people with significant nerve damage, although function may not return, a laminaplasty can help keep their condition from progressing.