Houston Methodist. Leading Medicine

Neck FAQ

Question:

Have you ever heard of a double-door laminoplasty? This is what the surgeon is saying I should have done for my severe neck problems. My formal diagnosis (at least on paper) is cervical myelopathy. The procedure won't touch the bone spurs that are causing the problem, so how is that going to help me?

Answer:

Problems in the neck that can cause severe pain, numbness down the arms, and sometimes even paralysis are referred to as cervical myelopathy. Cervical myelopathy can be caused by several changes that occur over time. Bone spurs along the front of the vertebrae are included in that list. Ossification (hardening) of the ligament that goes down the back of the spine (posterior longitudinal ligament or PLL) is a second potential cause of cervical myelopathy. Another is the herniation of several discs in the cervical spine (neck) with resultant spinal canal stenosis (narrowing caused by disc material pushing into the canal). A successful treatment for this problem is laminoplasty surgery to take pressure off the spinal cord and stabilize the spine. A double-dooor laminoplasty splits the spinous process down the middle and then opens them up like french doors or two windows that open towards you. The spinous process is the bone along the back of the vertebra that you feel as a "bump" down the spine. The effect of this procedure is to allow the spinal cord to shift backwards or "move away" from the front of the spine. The result is to take pressure off the spinal cord (called decompresson). Relief of painful (or other) symptoms with improved motion and function can be expected. This posterior approach has more advantages than disadvantages when there are protruding discs at several levels. Likewise, this posterior laminectomy works well when there are bone spurs along the front of the vertebral bones or a stiff, tight ligament along the back of the vertebrae. With the posterior decompression, pressure is removed from the spinal cord without removing the discs, spurs, or ligaments. With this surgical approach, normal structures (ligaments, muscles) are preserved so there are fewer complications related to the operation. Seok Woo Kim, MD, PhD, et al. Is Cervical Lordosis Relevant in Laminoplasty? In The Spine Journal. August 2013. Vol. 13. No. 8. Pp. 914-921.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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