What it is
Rather than removing the bony arch over the spinal cord or fusing the segments, laminoplasty hinges the arch open on one side and holds it in its new position with small plates. The canal is enlarged, the cord has room, and the neck is not fused.
Who it is for
Multi-level cervical myelopathy — typically three or more levels — in a neck that retains a normal forward curve. It is not suitable where the neck is already kyphotic, where there is significant instability, or where axial neck pain is the dominant symptom, because laminoplasty does not treat neck pain.
How it works
Through a midline incision at the back of the neck, a trough is cut on one side of the lamina at each level and a hinge is created on the other. The arch is lifted open like a door and held with small plates, enlarging the canal across every level treated.
Recovery
Usually one to two nights in hospital. Neck soreness and stiffness are expected early and improve over weeks; early range-of-motion exercises matter here more than after a fusion, precisely because motion is what the operation set out to preserve.
Risks and alternatives
Bleeding, infection, persistent neck pain, loss of some neck motion despite the aim, and weakness in the shoulder from traction on the C5 nerve root — uncommon, usually temporary, and a recognized complication of all posterior cervical decompressions. Alternatives are posterior decompression and fusion, or an anterior approach.