Motion Preservation Cervical Laminoplasty

Cervical laminoplasty is primarily recommended for patients experiencing progressive spinal cord compression, or myelopathy, which can lead to symptoms such as weakness, numbness, impaired coordination, and difficulty walking. It is most commonly indicated in cases where multiple levels of the cervical spine are affected, making it a suitable alternative to multi-level spinal fusion.

are the conditions that may necessitate cervical laminoplasty?

• Cervical spondylotic myelopathy (CSM): A degenerative condition where wear-and-tear changes cause narrowing of the spinal canal, compressing the spinal cord.
• Ossification of the posterior longitudinal ligament (OPLL): A condition in which the ligament running along the back of the vertebral bodies hardens, reducing space for the spinal cord.
• Congenital or acquired spinal stenosis: Narrowing of the spinal canal that can be present from birth or develop over time due to degenerative changes.
• Multi-level cervical disc disease: When disc degeneration leads to compression at several levels of the cervical spine, requiring decompression.

Laminoplasty is generally preferred when spinal cord compression exists without significant spinal instability. It is particularly beneficial for individuals who wish to preserve as much range of motion as possible while addressing their neurological symptoms.

Ideal candidates for cervical laminoplasty are those with multi-level spinal cord compression due to conditions such as cervical stenosis or OPLL but who do not have significant spinal instability or severe misalignment. Patients who are good candidates for the procedure typically exhibit:

• Evidence of spinal cord compression on imaging: MRI or CT scans must confirm significant narrowing of the spinal canal leading to myelopathy.
• Symptoms of cervical myelopathy: Including clumsiness, hand weakness, gait disturbances, and balance issues.
• Good cervical spine alignment: The procedure is most effective in individuals with a neutral or slightly curved cervical spine, rather than those with severe kyphosis (abnormal forward bending).
• No significant neck instability: Unlike spinal fusion, laminoplasty does not provide additional stability, making it unsuitable for patients with severe instability or spondylolisthesis (slipping of vertebrae).
• Desire to maintain cervical motion: Laminoplasty is often chosen by younger or more active patients who want to retain movement in the neck.

One of the key advantages of cervical laminoplasty over traditional fusion surgery is its ability to maintain movement in the cervical spine. Other benefits include:

• Reduced risk of adjacent segment disease: Since laminoplasty does not involve fusing vertebrae, it reduces the strain on nearby spinal segments, lowering the risk of future degeneration.
• Preserved neck mobility: Patients retain a greater range of motion compared to those undergoing multi-level fusion.
• Effective spinal cord decompression: By expanding the spinal canal, laminoplasty provides relief from symptoms of myelopathy and prevents further neurological decline.
• Minimized need for additional surgery: In contrast to fusion, which may lead to additional surgeries due to stress on adjacent vertebrae, laminoplasty preserves natural movement and reduces the likelihood of further interventions.