10/23/2016

CervicalLaminoplastyRoushSpine|RoushSpine

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Dr.HieuBall,M.D.
Dr.ThomasF.Roush,M.D.
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CervicalLaminoplasty

Acervicallaminoplastyisaspinesurgerythatinvolvesreshapingand/orrepositioningbonetorelieveexcess
pressureonthespinalnerve(s)inthecervicalspine,orneck.
Acervicallaminoplastyisoftenperformedtorelievethesymptomsofspinalstenosis,thenarrowingofthe
spinalcanal.

WhatIsACervicalLaminoplasty?
Acervicallaminoplastyisaspinesurgerythatinvolvesreshaping/repositioningbonetorelieveexcesspressure
onthespinalnerve(s)inthecervicalspine,orneck.ThenameoftheprocedureisderivedfromtheLatinword
lamina(thinplate,sheetorlayer),andtheGreektermplastos(tomold).Alaminoplastydiffersfroma
laminectomyinthatthelaminaisrepositionedratherthanremoved.

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WhyDoINeedThisProcedure?
Spinalstenosisisaconditioncausedbyagradualnarrowingofthespinalcanal.Thisnarrowinghappensasa
resultofthedegenerationofboththefacetjointsandtheintervertebraldiscs.Thefacetjointsalsoenlargeas
theybecomearthritic,whichcontributestoadecreaseinthespaceavailableforthenerveroots.Bonespurs,
calledosteophytesalsocanformandgrowintothespinalcanal,andconnectingligamentsalsomaythicken.
Theseprocessesnarrowthespinalcanalandmaybegintoimpingeuponandplacepressureonthenervesroots
andspinalcord,resultinginsuchsymptomsas:
Neckpain
Painthatradiatesintotheshoulders,armsand/orhands
Numbness,tinglingandmuscleweaknessintheneckand/orupperextremeties
Boweland/orbladderimpairment
Thegoalofacervicallaminoplastyistorelievepressureonthespinalnervesbyremovingthesourceofthe
pressurewhilestillmaintainingthestabilityoftheposteriorelementsofthevertebrae.Theprocedurealsois
referredtoasanopendoorlaminoplastybecauseitinvolveshingingonesideoftheposteriorelementsof
thevertebraeandcuttingtheothersidesothatitformsadoorwhichisthenopenedandheldinplacewith
wedgesmadeofboneandinstrumentation.
Todeterminewhetheryourconditionrequirestreatmentwithacervicallaminoplasty,yourdoctorwillexamine
yourbackandyourmedicalhistory,andmayorderanXray,computedtomography(CT)scanormagnetic
resonanceimaging(MRI)scanofyourspine.Asurgicalproceduresuchasacervicallaminoplastyistypically
recommendedafternonsurgicaltreatmentoptions,suchasmedication,restandphysicaltherapy,failtorelieve
symptomsafterareasonablelengthoftime.

HowIsACervicalLaminoplastyPerformed?
Theoperationisperformedwiththepatientonhisorherstomach,sedatedundergeneralanesthesia.Througha
smallincisionmadeatornearthecenterofthebackoftheneck,yoursurgeonwill:
Cutagroovedownonesideofthecervicalvertebra(e),creatingahinge
Cutthroughtheothersideofthevertebra(e)
Removethetipsofthespinousprocesses,tocreateroomforthebonestopullopenlikeadoor
Bendthebackofeachvertebreopenlikeadooronitshinge,removingpressurefromthespinal
cord/nerves
Removeanyothersourcesofcompressioni.e.,bonespurs,discmaterialorexcessligament
Placesmallwedgesofboneintheopenspaceofthedoor,andthensecurethedoorintheopenposition
withinstrumentation
Easethesofttissuesbackintoplaceandclosetheincision.

HowLongWillItTakeMeToRecover?
Yoursurgeonwillhaveaspecificpostoperativerecovery/exerciseplantohelpyoureturntoyournormal
activitylevelassoonaspossible.Followingacervicallaminoplasty,youmaynoticeanimmediateimprovement
ofsomeorallofyoursymptomsothersymptomsmayimprovemoregradually.
Theamountoftimethatyouhavetostayinthehospitalwilldependonyourtreatmentplan.Insomeinstances,
thisproceduremaybedoneonanoutpatientbasis.Youtypicallywillbeupandwalkinginthehospitalbythe
endofthefirstdayafterthesurgery.Yourreturntoworkwilldependonhowwellyourbodyishealingandthe
typeofwork/activitylevelyouplantoreturnto.
Workcloselywithyourspinalsurgeontodeterminetheappropriaterecoveryprotocolforyou,andfollowhisor
herinstructionstothelettertooptimizethehealingprocess.Todeterminewhetheryouareacandidatefora
cervicallaminoplasty,pleasetalktoyourdoctor.

AreThereAnyPotentialRisksOrComplications?
Alltreatmentandoutcomeresultsarespecifictotheindividualpatient.Resultsmayvary.Complicationssuchas
infection,nervedamage,bloodclots,bloodlossandbowelandbladderproblems,alongwithcomplications
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associatedwithanesthesia,aresomeofthepotentialrisksofspinalsurgery.Apotentialriskinherenttospinal
fusionisfailureofthevertebralboneandgrafttoproperlyfuse,aconditionthatmayrequireadditionalsurgery.
Pleaseconsultyourphysicianforacompletelistofindications,warnings,precautions,adverseeffects,clinical
resultsandotherimportantmedicalinformationthatpertainstothecervicallaminoplastyprocedure.
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Theinformationappearingonthiswebsiteisnotintendedtobeasubstituteforprofessionalmedicaladvice.Alltreatmentandoutcomeresultsarespecifictoindividualpatients.
Resultsmayvary.Complications,suchasinfection,bloodloss,andbowelorbladderproblemsaresomeofthepotentialadverserisksofspinalsurgery.Pleaseconsultyour
physicianforacompletelistofindications,warnings,precautions,adverseevents,clinicalresults,andotherimportantmedicalinformation.Youshouldnotusethisinformation
todiagnoseortreatahealthproblemordiseasewithoutconsultingwithaqualifiedhealthcareprovider.

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