Laminoplasty is a surgery performed to treat spinal disorders that cause spinal cord compression. At the back of the spine, between the facet joints, is the lamina; a thin plate of bone that helps to protect the spinal cord. Instead of removing all (laminectomy) or part (laminotomy) of the lamina, during laminoplasty the lamina is scored and opened like a door. Small plates made of metal or bone fix the lamina in the new position (e.g., fuses into position).
Spinal stenosis, bone spurs (osteophytes), disc herniation, degenerative changes, or tumors are problems that can compress the spinal cord at one or more levels of the spine. Pressure on the spinal cord can cause myelopathy, spinal cord dysfunction. Symptoms of myelopathy may include generalized weakness, pain, numbness, problems with balance or coordination, difficulty walking, and problems with fine motor skills such as buttoning a shirt.
Depending on the patient’s diagnosis, Dr. Stieber may recommend laminoplasty as a surgical option to remove the pressure off the spinal cord. Laminoplasty may help the spinal cord to heal and cause symptoms to go away.
Laminoplasty is performed under general anesthesia. The neck and back are cleansed and prepared for surgery. A special monitoring system checks the spinal cord to prevent cord injury throughout the procedure. The procedure may be performed by approaching the spine from behind (posterior) using minimally invasive techniques or as an open procedure (large incision). Dr. Stieber determines which surgical approach is best and discusses the entire procedure with the patient well in advance of the surgery date.
The right and left sides of the laminas are scored, cut, and folded back, which creates a hinge on both sides. Pressure is removed from the spinal cord, as is disc material and/or bone spurs. This allows spinal fluid to flow more normally. To hold the lamina open, a small implant made from metal or bone is added. Intra-operative imaging ensures the implant(s) are in proper position and secure. The surgical incision is closed and bandaged.
After surgery, the patient is moved into the recovery area. In recovery, nurses and other members of the medical team closely monitor the patient’s vital signs – pulse, respiration, blood pressure, and pain. Some post-operative pain should be expected, and patients receive pain medication either through their IV (intravenous line) or by mouth.
The patient is moved from recovery into a hospital room for a 2 to 3 day stay. A post-operative brace is prescribed for the patient to wear for several weeks. The brace helps to immobilize and support the spine as it heals.
After Care at Home
Dr. Stieber provides laminoplasty patients with information about what to expect and self-care after hospital discharge. This information includes instructions to control pain, medications, brace use and care, diet and managing constipation, bathing and incision care, activity restrictions, and surgical follow-up appointments. As always, Dr. Stieber and his staff welcome questions and ensure that all patient concerns are thoroughly addressed.