Introduction
The cervical spine consists of a series of small vertebrae in the neck that encase the spinal cord within their openings. This spinal cord is crucial for transmitting signals between the brain and the body. Certain degenerative conditions can cause the spaces in the spine to narrow, leading to pressure on the spinal cord and nerves. This pressure can disrupt their function and result in pain.
A cervical laminaplasty is a surgical intervention designed to enlarge the opening in the bone, alleviating pressure on the spinal cord and nerves. This procedure can help alleviate symptoms and enable individuals to return to their preferred activities. While laminaplasty may not restore full function in cases of severe spinal cord or nerve damage, it effectively halts further progression of the condition.
Anatomy
The spine is divided into regions characterized by distinct curves and functions. The cervical spine, located in the neck, comprises seven small vertebrae.
Each vertebra has a back section that arches to form a protective covering known as the lamina. The spinous process is a slender bone extending from the center of the lamina, often referred to as the "backbone," which can be felt along the spine. This area serves as an attachment point for muscles and ligaments.
The central opening of each vertebra forms the spinal canal, through which the spinal cord, nerves, and blood vessels traverse. Nerves exit the spine to relay information to the brain concerning the shoulders, arms, and hands.
Causes
Cervical laminaplasty is indicated for specific degenerative spine conditions that exert pressure on the spinal cord and nerves. The procedure surgically enlarges the lamina, creating additional space within the spinal canal to relieve this pressure. After the opening, the lamina is reconstructed to ensure continued protection of the spinal cord.
Symptoms
Degenerative spinal conditions compressing the spinal cord in the cervical region can lead to pain, tingling, or numbness in the neck, which may radiate to the shoulders and arms. Patients may also experience functional impairments, including weakness or coordination issues, as well as headaches.
Diagnosis
A physician can diagnose degenerative spine diseases through a physical examination and imaging studies. These may include X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans. Based on the findings, your doctor will determine your suitability for laminaplasty.
Treatment
Laminaplasty is performed as an inpatient procedure. It involves opening the lamina to relieve pressure on the spinal cord while modifying it to maintain a protective covering at the back. Several techniques exist for performing laminaplasty, and your doctor will discuss the most appropriate method for your case.
One approach involves a complete incision on one side of the lamina with a partial incision on the opposite side, creating a “hinged door.” Another technique, known as the “French Door Method,” entails a full incision down the middle of the lamina with partial incisions on either side, resulting in two “doors” that open towards each other. During the surgery, the projections of the spinous process are removed to facilitate the opening of these doors, which relieves pressure on the spinal cord and nerves. Bone fragments or surgical hardware are then inserted to keep the “doors” open and protect the spinal cord. Once the procedure is completed, the incision is closed and bandaged.
Patients usually stay in the hospital for several days after laminaplasty. Engaging in physical therapy can aid in restoring neck strength and flexibility. While some may notice immediate improvements, for others, recovery may take time. For individuals with significant nerve damage, even if full function does not return, laminaplasty can help prevent further deterioration.
