Laminectomy, Laminotomy, and Laminoplasty for Cervical Spinal Stenosis
A laminectomy involves the removal of a fairly substantial portion of structural material from the spinal column. The lamina is a thickened, bony ligament at the back of the spine that covers the spinal canal. This ligament can thicken and cause spinal compression on its own, but it is also often removed to simply allow the cervical spine to decompress by having more space to relax into. If a laminectomy is only being performed at one level in a fairly immobile portion of the lumbar or thoracic spine then spinal fusion is not always required. However, the movements of the cervical spine may become unstable if the lamina is removed, especially if this is over two or more segments, with cervical spinal fusion usually carried out to ensure no trauma occurs with hypermobility.
Laminotomy or laminoplasty may be more appropriate for some patients in the cervical spine as these can allow decompression whilst maintaining the structural support provided by the spine naturally. A laminotomy involves a much smaller ‘window’ being cut into the lamina on one side of the spine to allow decompression, and a laminoplasty is the creation of a door-like structure by cutting the side of the lamina and using metal instrumentation to hold it slightly ‘ajar’, thereby creating extra space. The degree of decompression achieved during such surgeries may be more difficult to assess than when performing an open laminectomy where the surgeon can view the spine most easily. The use of a fluoroscope during minimally invasive procedures can aid a surgeon in their assessment of nerve decompression.
Alternative Cervical Stenosis Surgery Options –> Spinal Fusion