Posterior cervical laminar shapping plate and laminoplasty is a common spinal fracture surgical method for treating multi segment cervical disc herniation and cervical spondylotic myelopathy.
It is to make an incision in the center of the back of the neck, cut off one side of the cervical vertebrae, lift the cervical vertebrae backwards, expand the cervical spinal canal, drift the compressed spinal cord backwards, relieve spinal cord compression, and alleviate symptoms such as walking instability, numbness in hands and feet, weakness in hands and feet, and neck pain.
The scope of posterior cervical fracture surgery should be evaluated based on preoperative X-ray, CT, and MRI, and the compression should be relieved wherever the spinal cord is heavily compressed. Usually, the surgical segment is from neck 3 to neck 6, occasionally reaching neck 7. Some patients also have significant compression in front of the spinal cord, and if the postoperative symptoms do not recover well, they generally need to undergo another anterior cervical spine surgery 3 months after surgery.
The incidence of complications in laminoplasty is comparable to or even lower than other spinal cord surgery procedures. Compared with anterior cervical surgery, posterior cervical surgery has a higher incidence of complications. Proper handling and preservation of soft tissue is crucial. After laminoplasty, the anterior convexity of the spine disappears, but severe kyphosis after multi segment laminectomy is rare. Postoperative C5 nerve paralysis is caused by multiple factors, not only during laminoplasty, but also after any type of cervical decompression surgery. The incidence rate of laminoplasty is the lowest, only 4.8%. Spinal cord injury is a rare complication in any spinal cord surgery, including laminoplasty. After laminoplasty, the incidence of recurrent stenosis or premature closure is 10%, most commonly occurring at the C5 or C6 level.
In summary, laminoplasty is an effective and safe internal fixation of fracture surgical method for treating multi segment spinal canal stenosis in the cervical spine. Compared with cervical laminectomy and laminoplasty, the advantages of laminoplasty orthopeadic implant include avoiding complications caused by fusion and preserving motor function. The key to the surgery is meticulous management of the extensor muscles, with special attention to preserving the soft tissue structure of C2 as much as possible.
