Cervical Laminoplasty: A Novel Surgery

Cervical laminoplasty is one of the newer and novel surgical procedures done on the neck for Cervical Spondylotic Myelopathy. This surgery is performed from the back of the neck.

This surgery is done in patients who have weakness due to compression of the spinal cord in the neck. Laminoplasty is a non-fusion surgery, which means that it does not lead to restriction of movement of the neck as opposed to fusion surgeries that cause restriction of the movement of the neck. It gives excellent results in appropriately chosen patients.

At Complete Orthopedics, our experienced surgeons use advanced techniques to provide personalized care and help patients return to improved function.

This page explains how it works, who may benefit from the procedure, and what to expect before, during, and after surgery.

Who Gets It

Cervical Laminoplasty is performed in patients who have spinal cord compression at multiple levels in the neck. These patients may have compression of the spinal cord due to wear and tear and aging changes. Some patients may also have underlying cervical spine stenosis These patients with stenosis have a smaller diameter of the spinal canal.

Patients with congenital spinal canal stenosis are at higher risk of developing spinal cord compression and its subsequent complications. An ideal patient for laminoplasty is one who does not have any neck pain or any pain going down into the arm (cervical radiculopathy). These patients have a good contour of their neck (Cervical Lordosis) and are not found to have any gross instability of the neck.

Imaging & Treatment

Prior imaging of the neck and sometimes the whole spine is done before the surgical treatment is planned. X-rays, MRI, and CT scans are performed to find the right candidate as well as do good surgical planning. Occasionally, the patient may have to undergo EMG and nerve conduction study before surgery to confirm the diagnosis. These patients usually have weakness in their legs, which manifests in the form of gait problems and imbalance. These patients may also have weakness in their hand and upper extremity.

Occasionally, thereby the patients who have more weakness in their upper extremity than their lower extremity as is the presentation of central cord syndrome. Patients who have pain in one or both upper extremities only are not a good candidate for the surgery. Also, patients who have an inflammatory disease of their neck including ankylosing spondylitis or rheumatoid arthritis are not good candidates for this type of surgery.

Patients who have weakness along with pain in one or both arm can be a candidate for the surgery along with decompression of their nerve root, which can be done at the same time.

AP and Lateral view X rays of Laminoplasty C3-6

AP and Lateral view X rays of Laminoplasty C3-6

Axial CT scan Post-op Laminoplasty

Benefits and Risks

One of the primary benefits of cervical laminoplasty is the relief from symptoms like pain, numbness, and weakness, thereby improving quality of life. Unlike procedures that fuse the vertebrae together, laminoplasty preserves the natural movement of the spine, which is significant for maintaining mobility​.

However, like any surgery, laminoplasty comes with risks. These include bleeding, infection, nerve damage, and in rare cases, spinal cord injury. Long-term complications might include loss of spinal alignment, kyphosis (forward curvature of the spine), recurrent stenosis, and lordosis (inward curvature of the spine)​.

Cervical Laminoplasty Recovery

Carefully selected patients who undergo laminoplasty do well after the surgery. They recover gradually over a period of time. Occasionally, they may have to go to rehab especially if their activities are grossly limited due to their disease process. Laminoplasty allows the patient to retain and recover there range of motion.

AP and Lateral view X-ray Post-op Laminoplasty and Posterior Spinal Fusion

AP and Lateral view X-ray Post-op Laminoplasty and Posterior Spinal Fusion

Alternative Surgical Options

If cervical laminoplasty is not suitable, other surgical options are available. A laminectomy involves removing the lamina to decompress the spinal cord but often requires spinal fusion, limiting mobility. A laminotomy, on the other hand, involves making a small hole in the lamina to relieve pressure without removing the entire structure.

Another option is an anterior cervical discectomy and fusion (ACDF), which is performed through the front of the neck and involves fusing the vertebrae. Total disc replacement (TDR) is also an option, aiming to preserve spinal motion by replacing the damaged disc with an artificial one​.

Long-Term Outlook

The success rate of cervical laminoplasty is promising, with studies showing that up to 70% of patients experience long-term relief from their symptoms. The outcome of the surgery depends on factors such as the patient’s overall health, age, the extent of spinal cord compression, and how long symptoms were present before surgery​.

Cost Information

This procedure under CPT code 63051 at Complete Orthopedics is covered by Medicare and most major insurance carriers (Aetna, Anthem BCBS, Cigna, Empire BCBS, UnitedHealthcare), as well as most workers’ compensation and no-fault insurance plans. Your out-of-pocket cost depends on your specific plan, deductible, and the medical necessity criteria that apply to your case.

Call our billing team at (631) 981-2663 before scheduling to verify your coverage and discuss expected out-of-pocket costs. For the full list of carriers we accept and patient billing protections, see our Insurance Information page.

Summary and Takeaway

Cervical laminoplasty is an effective, non-fusion procedure for treating cervical spondylotic myelopathy, offering significant symptom relief while preserving neck movement. It is ideal for patients with multi-level spinal cord compression without significant neck pain. As with any surgery, the procedure carries risks, but the prognosis is generally favorable, especially in carefully selected patients.