Laminoplastik

Laminoplastik, or laminoplasty, is a surgical procedure for decompression of the cervical spinal cord. Rather than removing a large portion of the posterior elements as in a laminectomy, laminoplasty reconstructs or reshapes the lamina to widen the spinal canal and relieve cord compression while preserving much of the posterior bony architecture.

Indications for laminoplasty include multilevel cervical spondylotic myelopathy and stenosis due to ossification of the posterior longitudinal ligament (OPLL), particularly when a broad decompression is needed across several levels. It is often considered when maintaining structural stability and posterior soft-tissue attachments is desirable or when fusion is not preferred.

Techniques vary, with the open-door laminoplasty and the double-door laminoplasty being the most common. In an open-door laminoplasty, the lamina on one side is hinged and the opposite side is cut to allow the lamina to open like a door, enlarging the canal. A spacer, bone graft, or implant is placed to hold the lamina in the opened position. In the double-door approach, the lamina is split along the midline and opened on both sides to create two “doors.” The goal is to achieve sufficient canal expansion while preserving the posterior elements and their attachments.

Outcomes depend on the underlying disease and level of stenosis. Many patients show neurological improvement and increased canal diameter, though risks include C5 palsy, dural tears, infection, hematoma, and postoperative spinal deformity if instability is not adequately addressed. Postoperative care typically involves immobilization and rehabilitation.