Cervical Laminectomies, Laminoplasties

Dr Roy Koh Kiok Miang
Consultant Neurosurgeon

What Is Cervical Laminectomy?

Cervical laminectomy is a surgical procedure aimed at relieving pressure on the spinal cord or nerve roots in the cervical spine (neck).

This pressure can result from various conditions, including spinal stenosis, herniated discs, tumours, or degenerative diseases that lead to the narrowing of the spinal canal. The procedure involves the removal of a portion of the lamina, which is part of a vertebra that covers the spinal canal, to create more space in the canal and reduce pressure on the spinal cord.

Procedure Overview

The cervical laminectomy procedure is conducted as follows:

Preparation

The patient is placed under general anaesthesia and positioned lying on their stomach or side, depending on the surgical approach.

Incision

A small incision is made in the back of the neck to access the cervical spine.

Lamina Removal

The surgeon removes the portion of the lamina that is causing compression on the spinal cord or nerve roots. If necessary, any bone spurs or other sources of compression are also removed.

Closure

The incision is closed with sutures or staples, and a dressing is applied to the surgical site.

Potential Risks and Complications

As with any surgical procedure, cervical laminectomy carries potential risks and complications, including:

  • Infection: Risk of infection at the incision site or within the spinal column.
  • Bleeding: Possible excessive bleeding during or after surgery.
  • Nerve Damage: Risk of accidental damage to the spinal cord or nerve roots, leading to weakness, numbness, or paralysis.
  • Instability of the Spine: Removal of the lamina can sometimes lead to instability in the spine, necessitating further surgical intervention such as spinal fusion.
  • Persistent Pain: Some patients may experience persistent pain or discomfort in the neck area after surgery.

What Is Cervical Laminoplasty?

Cervical laminoplasty is also a surgical procedure designed to relieve pressure on the spinal cord in the cervical spine.

Unlike laminectomy, which involves removing the lamina, laminoplasty reconstructs the lamina to create more space for the spinal cord without removing any parts of the vertebra.

Procedure Overview

The cervical laminoplasty procedure involves the following steps:

Preparation

The patient is placed under general anaesthesia and positioned lying on their stomach or side, depending on the surgical approach.

Incision

A small incision is made along the back of the neck to expose the cervical spine.

Lamina Reconstruction

The surgeon cuts on either side of the lamina but does not remove it. The lamina is then hinged open like a door, or small wedges are inserted to hold the lamina open, creating more space for the spinal cord.

Hardware Insertion

Small plates or screws may be inserted to secure the lamina in its new position, ensuring the spinal canal remains expanded.

Closure

The incision is closed with sutures or staples, and a dressing is applied to protect the surgical site.

Potential Risks and Complications

Risks associated with cervical laminoplasty include:

  • Infection: Risk of infection at the incision site or within the spinal column.
  • Bleeding: Possible excessive bleeding during or after surgery.
  • Nerve Damage: Accidental spinal cord or nerve root damage during surgery can lead to weakness, numbness, or paralysis.
  • Hardware Failure: The plates, screws, or spacers used to hold the lamina open may fail, move, or cause irritation, potentially requiring additional surgery.
  • Reduced Spinal Mobility: Some patients may experience reduced neck mobility due to the changes in the spinal structure.
  • Persistent Pain: Some patients may experience persistent pain or discomfort in the neck area after surgery.

Choosing Between the Two Procedures

When deciding between cervical laminectomy and laminoplasty, several factors must be considered to determine the most appropriate surgical intervention for relieving spinal cord or nerve root compression in the cervical spine.

The extent and location of spinal compression can influence the choice of procedure.

Patients with significant spinal instability or deformity may require laminectomy and fusion.

Younger, more active patients may benefit more from laminoplasty due to its potential for preserving spinal motion.

Dr Roy Koh Kiok Miang

Consultant Neurosurgeon

Dr Roy Koh has expertise to manage a wide variety of neurosurgical and spinal problems. He was the first Neurosurgical Spine Consultant at KTPH and also performed Singapore’s first minimally invasive removal of a Spinal Tumor.

  • MBBS, National University of Singapore (NUS) in 2000
  • Basic Surgical Training in 2004
  • MRCS (Edin) and Master in Medicine(Surgery) in 2006
  • Neurosurgical Advanced Surgical training in 2008
  • Fellowship with Neurosurgical Department in Addenbrookes Hospital, Cambridge

Dr Koh has been active in pursuing his love for neurosurgery and spine surgery. He has also been an invited surgeon to places like India and visiting specialist surgeon for the Vietnamese Neurosurgical Congress in 2013, showcasing his new minimally invasive spine techniques to our neighbours.

Dr Koh is an Adjunct Assistant Professor in the Yong Loo Lin School of Medicine, where he is an MBBS examiner, and actively involved in training of the next generation of doctors.

Read Full Bio

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    Cervical Laminectomies, Laminoplasties in Singapore

    Frequently Asked
    Questions

    Are there any alternative treatments to these surgical procedures?

    Yes, alternative treatments may include physical therapy, pain management strategies such as medications or injections, and lifestyle modifications. However, when these conservative treatments fail to relieve symptoms, surgery may be recommended.

    What can I do to ensure the best possible outcome from surgery?

    Following your surgeon’s post-operative care instructions closely, including attending all recommended physical therapy sessions, avoiding activities that may strain your neck, and maintaining a healthy lifestyle, can help ensure a successful recovery.

    Will I need to wear a neck brace after surgery?

    The need for a neck brace varies depending on the procedure and patient factors. Some patients may wear a neck brace after surgery to support the neck as it heals.

    Is there a risk of needing additional surgeries in the future?

    While both procedures aim to provide long-lasting relief, there is always a risk that future spine problems could require additional surgeries. Factors such as the progression of degenerative diseases, lifestyle, and overall spinal health play a role in this risk.