LAMINOPLASTY SURGERY
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LAMINOPLASTY SURGERY INDIA - INTERNATIONAL PATIENT SERVICES Cervical stenosis :Can place pressure on the spinal cord in the neck region. The result of pinching of the spinal cord can be an insidious loss of coordination, loss of balance during walking, and even bowel and bladder incontinence. If most of the compression is in the back, this condition can be treated with a posterior cervial laminectomy. The objective of this procedure is to remove the lamina (and spinous process) to give the spinal cord more room. The spinal cord is especially sensitive to injury, and once the progression of pinching leads to significant loss of function, this function may not be reversible even with removal of the offending agent(s)
If a posterior laminectomy alone is done, there is a post-operative risk of developing instability that may lead to pain and deformity. In the image at left, note the resultant curve going the opposite way after the laminectomy, resulting in the spinal cord (blue) being draped over the bone and soft tissue. Posterior Laminoplasty In order to reduce the risk of post-operative instability and to avoid a fusion, some surgeons will recommend lifting the lamina on one side and leaving a hinge on the other side. The advantage of this technique is that it increases the size of the canal but leaves the posterior tether that helps keep the spine stable. The disadvantage is that it may not be as easy to decompress the nerves on both sides as they exit the foramen.
The potential risks include : Dural tear (cerebrospinal fluid leak) < 1% infection rate Bleeding Increased pain "collapse" of the hinge Instability in the spinal column Progressive kyphosis Death A dural tear, which occurs 1% - 2% of these surgeries, does not change the result of surgery, but post-operatively the patient may be asked to lay recumbent for one to two days to allow the leak to seal.
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