Laminoplasty

Multisegment degenerative cervical stenosis with progressive neurologic impairment and other symptoms can be surgically treated with anterior and/or posterior decompressive procedures with or without stabilization and fusion. Posterior procedures, including laminoplasty and laminectomy with fusion, offer the potential to effectively decompress the spinal cord over many levels, most commonly C3 to C7, when the correct indications are met. Preoperative considerations include the number of stenotic levels, the presence or absence of cervical lordosis, and any component of axial neck pain. Although both laminoplasty and laminectomy/fusion have supporters, laminoplasty may provide spinal cord decompression while sparing motion. Many laminoplasty techniques have been described but all essentially comprise a method of opening the posterior elements and a strategy for maintaining the "open" position. (C) 2007 Elsevier Inc. All rights reserved.