Laminoplasty was first performed by hinging the bone open and holding it in place with a piece of bone...
Evolution of Cervical Decompression
Treatment of cervical stenosis is by decompression, meaning relieving the pressure on the spinal cord and/or nerve root. This is done most often done through an anterior or posterior approach to the spinal cord depending on where the compression is coming from. An anterior approach is used when the intervertebral disc is the etiology of compression. A posterior approach is used for most other causes of cervical stenosis, as it allows for better removal of bone or soft tissues that may be constricting the spinal cord.
Often the bone on the back of the vertebra can be removed carefully opening up the space around the spinal cord and relieving the pressure. However, with removal of the posterior bone from the vertebra this can destabilize the spine requiring a fusion to be performed. Fusions are performed by placing screws into the vertebral body from the back of the neck and connecting them with metal rods. This effectively removes all motion between levels.
New techniques have been developed however that relieve compression of the spine without causing instability and therefore do not require fusion. The most popular of these is laminoplasty. With this technique, the posterior bone is not removed, but manipulated similar to opening a door partially to allow for increased room within the spinal canal. The “open door” is held in place with either a small metal plate or a piece of bone.