Laminoplasty is an orthopedic procedure of surgery, performed to treat the spinal stenosis. The surgery is performed to relieve the pressure existing in the spinal cord. Lamina is cut on both sides of the vertebrae that has been affeted. The spinal stenosis is also called as cervical spinal stenosis and it can be caused from fracture, bone spurs, arthritis, degenerative changes or disc herniations. The spinal stenosis can also be ocured in various levels present in the cervical spine cord, simultaneously and if the pressure is considerably more, spinal cord damage symptoms may be developed. The technique used for this is, open door laminoplasty, as the vertebrae back is made to be swung and then open it, just like a door. Laminoplasty Procedure in India is performed at world class hospitals having excellence in neuro-spine procedures
The procedure for laminoplasty involves hinging at one side of the spine’ posterior elements to be open, so that the pressure over the spinal cord an be relieved.
The procedure starts with a small incision made at the back side of the neck. The muscles and fat are held awayfrm the lamina bone, with the help of retractors. Compressive structures and bones are not removed, but the spinal cord, that is overlying is thinned out at one side uing a drill. The opposite side of cord is cut in the way through uing a drill. Such arrangement makes hinge at one side and the other side the other side would have a small opening. The lamina bone is then elevated on its open side. It makes enough space and room made availbale for the cord and the pressure would be taken off from it. The bone will be then held open at the hinged position using metal plates.
In some of the cases, a small drain is left and it would be brought to separate site, through the skin. It is done to monitor to check the continued bleeding. The same thing will be removed on the next day of the surgery. After the surgery is completed, each layer, which is incisioned, will be closed by using non-absorbable or absorbable uture material or sometimes surgical staples are ued. In case the external layer or the outer inciion is closed, using the non-absorbable sutures or staples, these are to be removed after healing of the incision.
Potential risks and complications involved in laminoplasty are,
- Numbness or pain caused from nerve manipulation
- Leak of cerebrospinal fluid
- Weakness or paralysis that might be caused from nerve root damage or spinal cord
- Impotence or inconsistence of bladder or bowel
- Injury or bleeding in major blood vessels
- Complications related to the anesthesia
After the Surgery
Patients have to continue to stay in hospital for one or two days, after the surgery. There could be neck pain at its back and it might be severe. This condition could be continued for many days, after the surgical procedure is performed. The pain is reduced gradually. The mobility of the patient is dependent on various factors, like age, pre-operative conditions, etc. Though patients are encouraged to walk after the surgery, harder activities like bending, twisting or lifting heavy weights are to be avoided till many weeks after the surgery. It should ideally be followed until the wound is completely recovered. After a few days, the vital signs will become stable and the patient would be able to walk by own, eat without feeling of nausea and can return to normal and regular activities, including normal bladder activity. But driving is not supposed to be done, during the narcotic pain medication. There would be no need for any speial equipment needed to be used at home.
Cost of Laminoplasty Procedure
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