[Laminoplasty].

OBJECTIVE

The aims of laminoplasty are to expand the spinal canal, to secure spinal stability, and to preserve the protective function of the spine. Preservation of mobility is also a goal of this procedure for multiple-level involvement.

INDICATIONS: Multisegmental spondylotic myelopathy with a relatively narrow spinal canal (anteroposterior spinal canal diameter<13 mm).

CONTRAINDICATIONS: Spinal instability. Kyphotic cervical spine.

SURGICAL TECHNIQUE: Prone positioning of the patient. Three-point pin fixation device such as Mayfield tongs to secure the head. Midline posterior approach to the spine. Exposure of the laminae and the spinous processes. Opening and expanding of the spinal canal, decompression of the spinal cord. Fixation of the laminae with bone and/or implants.

POSTOPERATIVE MANAGEMENT: Cervical collar for 3-4 weeks.

RESULTS

Long-term investigations have shown neurological improvement in 57%, a decrease of range of motion in 36%, and a slight reduction of lordosis without clinical relevance.