Question:My mother had a laminotomy of the C2 and C3 areas. I notice now that her neck seems so much straighter. Is that part of the operation or something else?
Answer:Laminotomy is a surgical procedure that removes part of the lamina of the vertebra. The lamina is the bone that curves around the spinal cord and forms an arch to protect the cord. Taking a piece of the lamina out removes pressure from around the spinal cord and/or the spinal nerve root at that level.
There are various ways to do a laminotomy. There is a lamina on each side of the vertebra connected in the middle by the spinous process. The spinous processes are what we feel as the bony knobs down the back of the spine. The neurosurgeon may remove the left or right half of one lamina.
It is more common that a portion of both sides of the lamina is removed. This leaves some of the laminae to preserve as much vertebral stability as possible. The surgeon can also perform a dome laminotomy. In this case, just the bottom half of the lamina is removed (rather than one side).
Most of the time, the extensor muscles of the neck are cut and stripped away from the vertebra before the bone can be removed. Although the surgeon reattaches the muscle, there may be a loss of cervical lordosis. Lordosis refers to the natural inward curve of the neck.
Scientists aren't exactly sure why this happens. It appears to affect women more than men. The cervical muscles tend to be atrophied (wasted away) and weak before the operation.
Cutting and restoring them may be enough to alter other functions besides strength. This may include kinesthetic or proprioceptive perception. These functions allow the joints and muscles to work together to move the right amount for each motion and to sense movement through space.
Women seem to be affected more than men with loss of cervical lordosis after laminotomy. The reasons for this remain unknown. It's also not clear what (if any) rehab is needed to restore full function, alignment, and posture.Haku Iizuka, MD, et al. Cervical Malalignment After Laminoplasty: Relationship to Deep Extensor Musculature of the Cervical Spine and Neurological Outcome. In Journal of Neurosurgery: Spine. December 2007. Vol. 7. No. 6. Pp. 610-614.
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