Laminoplasty

When the spinal canal in the neck is narrowed at several levels, a laminoplasty can often correct the problem by widening the canal like opening a door, protecting the spinal cord while preserving motion.

What Is a Laminoplasty?

A laminoplasty is a surgery on the back of the neck that makes more room for the spinal cord without removing the bony roof of the spinal canal. Instead, the lamina at each level is cut on one side and partly thinned on the other, so it can swing open like a door. Small plates or bone spacers hold the “door” open, permanently widening the canal.

Laminoplasty is used to treat cervical myelopathy, compression of the spinal cord in the neck caused by stenosis, cervical spondylosis or OPLL. Because no fusion is needed, it keeps more of the neck’s natural movement than a laminectomy with fusion.

Who Needs a Laminoplasty?

• Signs of spinal cord compression: clumsy hands, trouble with buttons or handwriting, dropping things, or feeling unsteady when you walk
• Stenosis or OPLL at three or more levels of the neck
• A neck with its normal forward curve and without instability
• Patients who would like to preserve neck motion

Laminoplasty may not be the best choice if your neck has lost its normal curve, is unstable, or if neck pain is your main symptom. In those cases, Dr. Grunch may recommend a cervical laminectomy with posterior fusion, or an operation from the front of the neck.

Call 911 or go to the nearest emergency room if you have sudden weakness in your arms or legs, sudden trouble walking, or new trouble controlling your bladder or bowels.

Treatments to Try First

When the spinal cord is compressed and causing symptoms, physical therapy, medications and injections can’t relieve the pressure. Because myelopathy tends to worsen over time and spinal cord damage may not fully recover, surgery is often recommended, and it can often correct the problem and prevent further damage.

How a Laminoplasty Is Done

1. Anesthesia and monitoring: You’ll be fully asleep, and nerve monitoring is used to protect your spinal cord.
2. Positioning: Your head is held securely, and you’re positioned face down.
3. Incision: An incision is made in the middle of the back of the neck.
4. Creating the hinge: At each level, a groove is made in the lamina on one side to create a hinge, and the lamina is cut through on the other side.
5. Opening the door: The laminae are gently lifted open, widening the canal and taking pressure off the spinal cord.
6. Holding it open: Small titanium plates or spacers hold each lamina in its new open position while the bone heals.
7. Closing: The muscles and skin are closed in layers.

This animation from Nucleus Medical Media shows how a cervical laminoplasty is performed. Click the image to watch it on YouTube:

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Video: Neck Surgery – Cervical Laminoplasty, courtesy of Nucleus Medical Media

Benefits and Risks

Benefits

• Relieves pressure on the spinal cord at many levels in one surgery
• Preserves neck motion, with no fusion
• Keeps a protective layer of bone over the spinal cord
• Lower risk of problems at neighboring levels than a long fusion

Risks

• Infection or bleeding
• Spinal fluid leak
• Temporary weakness lifting the arm at the shoulder (C5 palsy), which usually improves
• Neck pain or stiffness
• Spinal cord or nerve injury, which is rare
• Risks related to anesthesia

Why Choose Dr. Betsy Grunch for Your Laminoplasty

• Duke-trained: Dr. Grunch completed her neurosurgical residency and a spine research fellowship at Duke University School of Medicine, one of the top neurosurgery programs in the country, where she received the Spine Young Investigator Award.
• Minimally invasive by design: Minimally invasive spine surgery is one of her signature areas. She works through the smallest opening that will safely do the job, so you can get back on your feet sooner.
• Experience you can count on: She has been in practice since 2013 and performs 400 to 600 surgeries a year, more than 5,000 procedures over her career.
• Motion-preservation expertise: She performs laminoplasty as well as cervical disc replacement, so fusion isn’t your only option.
• Second opinions and revisions: She regularly sees patients who had spine surgery elsewhere and want a second opinion or need a revision.
• A teacher at heart: As “Ladyspinedoc,” she is known for explaining spine conditions clearly. You’ll leave your visit understanding your imaging and every option in front of you.

What to Expect

Before surgery

You’ll meet with Dr. Grunch or one of her physician assistants to review your imaging, your exam and your goals, and to decide together whether a laminoplasty is right for you. Our team will coordinate any pre-operative testing, review your medications (including blood thinners you may need to pause) and walk you through the day of surgery so nothing is a surprise. If you smoke or use nicotine, stopping before surgery lowers the risk of complications.

Procedure day

The surgery usually takes two to three hours. Most patients stay in the hospital for one to two nights.

Recovery timeline

• First two weeks: Walk every day. Neck soreness is common. Avoid lifting. Your first follow-up visit is about two weeks after surgery.
• Two to six weeks: Gradually increase your activity, and begin gentle neck motion as directed. Many patients return to desk work in four to six weeks.
• Six to twelve weeks: Physical therapy helps restore neck strength and motion.
• Three months and beyond: The hinges heal, and balance and hand function may keep improving for months.

Every patient heals differently. Your exact timeline will depend on your symptoms, your job and your overall health.

Frequently Asked Questions

How is a laminoplasty different from a laminectomy?

A laminectomy removes the lamina. A laminoplasty keeps it and reshapes it to widen the canal, which usually means no fusion is needed and more neck motion is preserved.

Will I be able to move my neck normally?

Most patients keep good neck motion, though some stiffness is common in the first months. Physical therapy helps.

Will my symptoms improve?

The main goal is to stop myelopathy from getting worse. Many patients also see improvement in balance, hand function and numbness, especially when surgery is done earlier.

Will I need a collar?

Some patients use a soft collar briefly for comfort. Early gentle motion is encouraged to prevent stiffness.

When can I drive?

You may drive once you’re off narcotic pain medication and can turn your head comfortably, usually two to four weeks after surgery.

Take the First Step Toward Relief

Myelopathy can quietly take away your balance and hand skills. Whether you need a treatment plan, a second opinion or a clear explanation of your imaging, Dr. Grunch and the Southern Neurosurgery team are here to help.

Call 470-293-9800 to schedule an appointment or contact us online.

Have a question first? Ask our virtual assistant anything, 24/7.

We see patients across metro Atlanta and North Georgia at our offices in Gainesville, Sandy Springs and South Atlanta (Riverdale). Find the office nearest you.

Related pages: Cervical myelopathy · OPLL · Cervical spondylosis · Cervical laminectomy · Posterior cervical fusion

This page is for educational purposes only and is not medical advice. It does not replace individualized care from a licensed physician. Please talk with your own doctor about your symptoms. If you have bladder or bowel changes, groin numbness or rapidly worsening weakness, call 911 or go to the nearest emergency room.