What is laminoplasty?

Laminoplasty is the surgical opening of a bony area of the spine called the lamina. There are two lamina on each vertebrae of your spine that form the back wall of your spinal canal. Your spinal cord runs through your spinal canal in the center of your vertebrae. 

Certain conditions of the spine can compress the spinal cord and cause pain. Laminoplasty hinges the lamina open like a door to create more space in your spinal canal without removing the lamina. Laminoplasty can relieve pressure in your spinal canal or on your spinal cord of your neck or back by widening your spinal canal.

Laminoplasty is an alternative to laminectomy. Laminectomy is the removal of all of the lamina. Unlike laminectomy, laminoplasty preserves spinal stability because the lamina is not removed. This may decrease the need for other procedures to stabilize the spine. It also helps maintain movement in your spine.

Laminoplasty is a common but major surgery with serious risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all your treatment choices before having laminoplasty. 

Types of laminoplasty

When laminoplasty involves one vertebra, it is called single level. When it involves more than one vertebra, it is called multilevel.

The types of laminoplasty procedures include:

  • Cervical laminoplasty is the hinging of lamina in the neck area (cervical spine). This is the most common use of laminoplasty. Not all surgeons perform the laminoplasty procedure.
  • Lumbar laminoplasty is the hinging of lamina in the lower back (lumbar spine).
  • Sacral laminoplasty is the hinging of lamina in the back between your pelvic, or hipbones (sacral spine).
  • Thoracic laminoplasty is the hinging of lamina in the middle part of the back (thoracic spine).
  • Other procedures that may be performed

Your doctor may perform other procedures in addition to laminoplasty. These include:

  • Discectomy is the surgical removal of part or all of a spinal disc. A discectomy treats herniated or ruptured spinal discs.
  • Foraminotomy is the widening of the opening where the nerve roots leave the spinal canal. Your doctor may use this procedure when the opening (foramina) is also narrowed causing pressure on the spinal nerves themselves (as opposed to the spinal cord).
  • Spinal fusion is the permanent joining together of two vertebrae using a bone graft. Sometimes, your doctor will also use screws, rods or plates to hold your vertebrae in place. This procedure permanently stops movement between the two vertebrae and limits the motion of your spine. 

Why is laminoplasty performed? 

Your doctor may recommend a laminoplasty to treat certain diseases and conditions of the spine. Your doctor may only consider laminoplasty for you if other treatment options with less risk of complications are ineffective, you suffer from spinal stenosis, and your quality of life is poor. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on a laminoplasty. 

Your doctor may recommend laminoplasty when you have spinal cord compression with symptoms of myelopathy. Myelopathy is impaired function of the spinal cord due to compression from the bones surrounding the spinal cord. Symptoms include weakness, pain, numbness, clumsiness, poor balance, difficulty walking, and stiffness in the extremities. The goal of laminoplasty is to relieve spinal pressure to stop myelopathy progression and potentially reverse the changes.

Laminoplasty preserves the stability and movement of your vertebrae. This can be an advantage by potentially decreasing the need for additional procedures to stabilize your spine. However, in an arthritic spine, movement is often related to pain, so laminoplasty tends to have inconsistent results for pain relief. 

Your doctor may recommend laminoplasty for persistent spinal symptoms caused by: 

  • Ankylosing spondylitis, a type of arthritis that causes inflammation of the spinal joints
  • Bone spurs, abnormal growths of bone on a vertebra, which can lead to compression of the spinal cord and nerves
  • Herniated spinal disc, displacement of the cushioning disc between the vertebrae 
  • Ossified posterior longitudinal ligament (OPLL), a thickening of the ligaments that run parallel to the spine
  • Spinal stenosis, a narrowing of the spinal column causing pressure on the spinal cord and nerves