Posterior Cervical Laminoplasty (Laminoplasty)
What is a Laminoplasty?
Laminoplasty is a surgical procedure designed to relieve the nerve pressure and pain caused by spinal stenosis. Spinal stenosis is a narrowing of the spinal canal that puts pressure on the spinal nerves. The pressure causes pain throughout the spine and extremities. It can develop as a result of certain genetic abnormalities, disease processes or simply due to natural aging.
Spinal stenosis can occur anywhere in the spinal column, in the cervical (neck), thoracic (chest), or lumbar (low back) regions. Generally, the symptoms of spinal stenosis worsen over time, and conservative treatments, such as medication and physical therapy become less effective in treating the condition. When this occurs, a Laminoplasty may become necessary. The procedure can provide relief from the typical symptoms of spinal stenosis, such as back pain and numbness or weakness in one or both arms or legs.
During Laminoplasty surgery, the lamina, a small section of bone that covers the back of the spinal cord, is cut through completely on one side and partially on the other, enabling it to swing open like a door. It is then held open with titanium spacers and plates, increasing the amount of room around the spinal cord and decreasing compression on the nerves.
A Laminoplasty can be performed on the any of the three regions of the spine. The region performed on depends on where the patient is experiencing the most intense symptoms. The operation may be performed from the back or the front of the body, depending on the particulars of the patient’s condition. If a bone spur is present nearer to the anterior of the body, the surgeon may enter the body from the front.
Is The Surgery Painful?
Please keep in mind that pain is a very subjective experience and one’s reaction to surgery is effected by a variety of factors mentioned above. The most common concerns we hear from patients after laminoplasty surgery are related to incisional discomfort and a discomfort around their scapula (or shoulder blade). Both of these tend to resolve prior to the first post-operative appointment at 2-3 weeks after surgery.
It is not uncommon for patients to experience “reminder” pain after surgery. This is when a patient begins to experience the same symptoms as they had before surgery. While this is common in recovery from spine surgery we understand that this can be very concerning to our patients. We encourage you to call the office with any concerns you may have after surgery.
laminoplasty vS laminectomy
A Laminoplasty is sometimes performed using microsurgery which is less invasive than traditional methods, but which requires both specialized training and specialized operating equipment. A Laminoplasty is a less intrusive alternative to another operation for stenosis called a laminectomy.
Unlike a laminectomy, a Laminoplasty does not remove the lamina and so manages to preserve spinal stability. This is an advantage because it helps the patient to maintain mobility and diminishes the need for future procedures to restabilize the spine.
What to Avoid Before Or After Surgery?
We ask that you refrain from taking any non-steroidal anti-inflammatory medicines should not be taken 10 days before surgery, and 10 weeks after surgery such as:
- Aspirin, Advil, & Aleve
- Herbal supplements
- Vitamins E & K
- Fish oil
If your physician recommends that you do not stop Aspirin prior to surgery, please be sure to discuss this with our office. You should discontinue all exposure to nicotine containing products two weeks before and at least 6 weeks after your surgery.
Laminoplasty Recovery period
After any type of Laminoplasty, patients need to undergo rehabilitative therapy to build up strength and flexibility in the area operated upon. Recovery times vary depending on the age and medical condition of the patient. Patients are restricted from activities that require bending or lifting for several weeks after surgery. Most can resume normal activities within 2 to 6 weeks. Patients who perform labor intense jobs are more likely to be out of work closer to 4 weeks. Most patients are able to begin driving, short distances, between 2-3 weeks after surgery. You may be a passenger in a car as soon as you feel up to it.
For the first 2-3 weeks, your activity will be limited to walking. We encourage you to walk as long as you are comfortable. During this time you may go up and down stairs, with the use of a railing, and you may also sleep in a normal bed. You will be limited to lifting 5 pounds for the first 2 weeks. After two weeks you will be able to resume low-impact cardiovascular activities and increase the amount of weight you are lifting. Within a reasonable amount of time after surgery, you will have very few restrictions on your activities. Please be sure to discuss any specific questions with us in the office.
We will provide you with isometric neck strengthening exercises that can be performed independently. If you are experiencing any motor weakness or balance changes before surgery we will likely recommend outpatient physical therapy after surgery.
What to expect after surgery
The first visit is 2-3 weeks after surgery however if you have any questions or concerns please call the office. If we think we should see you in the office we will schedule an earlier appointment.
Most patients do not have sutures that need to be removed. There are internal sutures that will dissolve with time. There will also be steri-strips (white pieces of tape) over the incision that will either fall off or we will remove them in the office.
- How long will I be wearing the soft collar?
The average amount of time patients wears the collar after a laminoplasty is 2-3 weeks.
- Will I set off metal detectors?
No, the titanium instrumentation does not currently set off metal detectors.
- Can I have an MRI after surgery?
Yes, the titanium instrumentation does not react to the magnet in the MRI machine however you should still notify the MRI facility of the presence of the instrumentation.
schedule a consultation
If you are suffering from spinal stenosis, laminoplasty surgery might be the right option for you. Call (212) 606-1004 to schedule a consultation with Dr. Todd Albert, Orthopedic Surgeon in NYC.