Cervical Laminoplasty Explained
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- Опубліковано 12 чер 2024
- Cervical Laminoplasty is a posterior surgery that creates more space for the spinal cord and is used to stabilize the the symptoms of Myelopathy. This video clearly outlines the surgical procedure, outcomes, risks and benefits of a cervical laminoplasty.
#thespineguy #cervicallaminoplasty #spinesurgery #laminoplastyplate #kyphosis #myelopathy #stenosis #spinalstenosis
Dr. Brian W. Su, MD
Spine Surgeon
Chief Development and Strategy Officer | California Orthopedics and Spine
Medical Director of Spine Surgery | Marin General Hospital
Director | Marin Healthcare District Board
Chairman | Marin Specialty Surgery Center
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Contact two locations:
www.caorthospine.com/
415-927-5300
2 Bon Air Road, Suite 120
Larkspur, CA 94939
7100 Redwood Blvd, Suite 200
Novato, CA 94945
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Disclaimer: This video is not intended to provide diagnosis, treatment or medical advice. Information obtained from this video should not be taken in lieu of your own medical provider's advice and treatment plan. Please consult directly with a physician or other healthcare professional regarding any diagnosis or treatment plan options. Content provided on this UA-cam channel is for informational purposes only and should not be considered as a substitute for advice from a healthcare professional. The statements made about specific products throughout this video are not to diagnose , treat, cure or prevent disease.
Just went through my 23 yr old daughter getting a plumb sized schwannoma removed from here thoracic spine. Our neurosurgeon was amazing. As kind, caring and explanatory as you are!! Now I'm having your favorite surgery done by the same ns next week. I didn't find you in the schwannoma searches in June, but I'm so thankful I found you now!! Your mom must be so proud!! Thank you thank you thank you. Such intellect, talent and humility are a rare find!! God bless.
Kim so happy for your daughter mom just had schwannoma almost same size wish I would’ve seen this video
I have ankylosing spondylitis and I have myelopathy and radiculopathy. Currently I'm redoing imaging so my neurosurgeon can determine whether or not I am a surgical candidate. I really appreciate your cervical stenosis videos, they have given me a lot of useful information. I am praying that I am a candidate for laminoplasty surgery. I feel empowered and educated Thank you Dr. Su❤
Just found out I have a bulging disk, arthritis and cervical stenosis and not being educated about this issue is to say the least very difficult to deal with, thanks to your videos and others I've found online I'm much more knowledgeable with this condition. Thanks for your help with educating me with this issue, looking forward to seeing more of your videos
Your channel is top notch. Great and very thorough information. Much appreciated.
Thank you for explaining the surgery I was so nervous about having the surgery.
Thank you for addressing my concerns. This is valuable.
Another amazing presentation
Thank you. Very informative and helpful
Great video. Thanks as always for helping us to understand these topics.
Great explanation.
Well explained-thanks
Finally made clear!!! Thank you Dr. Su!!!! 🙏🙏🙏🙏
Giving thanks to Doctor Ani John is something I will always take personal because he brought me back to my full health he is a good man and trustworthy so kind to every patient,
contact Dr.Ani John on UA-cam channel now for help for Any kind of health issues.
Great explanation Dr. Su
Giving thanks to Doctor Ani John is something I will always take personal because he brought me back to my full health he is a good man and trustworthy so kind to every patient,
contact Dr.Ani John on UA-cam channel now for help for Any kind of health issues.
MRI and appointment with my doctor next week. I hope this is the course of action that will help my condition.
Thank you so much Doctor, i like the way you explained everything so clearly. I am from Mauritius 🇲🇺 and suffering from cervical pain for about 15years and only this time on the MRI the report came with "Straightened cervical lordosis, Degenerative changes posterior elements, Osteophyte-disc complex with posterior bulging at C3/4, C4/5, C5/6. Spinal cord mompression at level C4/5, C5/6" Dr diagnosis " C3-C4, C4-C5, C5-C6 disc prolapse with Cervical kyphosis. I am in pain for months medecine does'nt help a lot even the stronger one.
Thx for explaining! I have exactly the same problems as you were describing. I immediately have ordered the Saunders machine at Ebay. Hopefully it will arrive soon here in the Netherlands to offer some relief. Dutch greetings from Perry
Hello! I hope the traction device helped you. I did just the same, ordering from eBay after checking with my physical therapist and prospective spinal surgeon and trying one in our rehab department. Mine came this week and I tried it for the first time yesterday. Immediate relief; what a delight! Best wishes.
Thank you Dr. Su for all of your easy to understand videos. Would love to hear your opinion on taking Bisphosphonates for osteoporosis. Thank you.
That is a better question for an endocrinologist
This is so very helpful and informative! I am 52 and I’ve had laminoplasty recommended by a surgeon at Golden State Orthopedics in Walnut Creek and Kaiser spine surgeon. I am terrified to have surgery since I’m still working and retire in 2 years - not sure if I’ll be able to return to work. Kaiser surgeon also told me I will have more pain after surgery for the rest of my life. :( quality of life is so important to me and I am super sensitive to pain. :( I would love to see what you think. Going to try to make an appt since I am also in Bay Area. Thanks so much.
did you get the surgery? how are you doing now?
Thank you for very clear explanations with easy-to-understand visuals and subtitles to reinforce key points. Is there a directory to find doctors who perform both laminectomy and laminoplasty? I live in South Carolina.
I am not aware of a directory for that
Thank you for such a clear and concise explanation. My first neurosurgical consult recommended fusion, which I was not happy with. I got a second opinion and was recommended to do the laminoplasy, which seemed like such a better option. After watching your video, I am feeling much more comfortable with this option. Very much appreciated.
did you get the surgery yet? how was it?
@@MusicLuv80 I had the surgery in February. It was pretty painful the first 3-4 days, but since then it’s been good. No range of motion restrictions and I’m back to doing jiu jitsu with no issues. All in all, I’m pretty satisfied with the results.
@@chrisviolanti2364 Wow that is incredible. Great news! Going back to jiu jitsu is awesome after the surgery.
Dr. Su you are a Hero, a Champion! 🏆 Lots of incredibly excellent and down to earth information.
Do you also use the french door technique?
Can the buckling of the ligamentum flavum with severe right neural compressive foraminal stenosis of C3-C4, C5-C6 cause compression of the central spinal canal? Thank you.
I use open door technique. No issues with foraminal stenosis.
Dr Su, Many thanks for creating these videos. You mentioned in one comment that Laminoplasty may not be suited for OPLL case. Any chance you can elaborate more on that. My MRI reports shows C5/C6 disc protrusion compressing the cord, and also a patch of dark thing compressing the cord from C5 to C7, potentially OPLL. I am going to have CT scan to see if those are calcification....
There is some literature that suggests that OPLL progresses because of persistent motion with laminoplasty
My personal experience has been with lumbar laminectomy, but I was also diagnosed with slight cervical stenosis so I keep educating myself in case it needs to be addressed surgically some day. I know insurance companies will make you jump through all kinds of hoops with PT before authorizing surgery. After watching this video, I wonder why they don’t prioritize cervical Laminoplasty over Laminectomy and fusion for most instances?
Habla español?? Como puedo contactarlo para una consulta desde México??
Just had this done 3 weeks ago
Could you please tell me what to do with backwards misalignment (stairstepped retrolisthesis) of c5
grade 1
Thank you so much for this video. I’ve just recently been diagnosed with cervical OPLL at 20 years old. I’m looking at different laminoplasty techniques and trying to understand the specific benefits and drawbacks of each method, namely ODL and DDL. Any advice or papers I could read? I really appreciate your content.
I would be cautious about doing a laminoplasty for opll. There is some literature that suggests advancement of the opl because of the persistent motion. I tend to recommend fusion in the case of opl. You should consult with your surgeon.
@@DrBrianSuTheSpineGuy I see, I was afraid of that. Thank you very much for your response.
Great video! Thank you for sharing. I already had a cervical infusion and after 2 years now a different surgeon wants to do an laminoplasty. Is this something you would recommend? They say I still have compression on my spinal cord.
I would have to look at the imaging studies. You can call 415-925-8200 for a second opinion by video with me
Dr. Su thank you for your info. I'm having Laminoplasty on Oct.3. 79 yrs old . Female. I have trouble with waking , balance , and dropping things also feeding myself. Both hands and fingers numb . My surgeon said this would be the best for me. going in from the back as some people my age have a hard time after swallowing . I do feel this is the best after your video . Thanks for any info .
Hope you are well. If possible please post how you made out. I think I'm in the same boat.
@@michaelkelly7740 I did very well. most symptoms are much better. only 5 months out . I get in the water for walking and exercise. fingers are still numb ,but not as bad . nerve pain is getting better . Just takes time . I think the worst part of this recovery is emotional . I never know if I will walk the same way again . That is ok , because with out the surgery you will never know . I went ahead with it and happy I did.
@@deannabain115 Delighted you are doing so well. And thank you for the report. My symptoms are similar but perhaps not as serious as yours were. They don't see to be worsening at this point, knock on wood. And fortunately I've never had any serious pain. The MRI report says cervical myelopathy. I meet with a neurosurgeon Apr 4th. At this point I'm reluctant to have surgery until worsening symptoms develop. Thanks again-- I wish you a continued good recovery!
@@michaelkelly7740 thank you, what I can say is don't wait to long if you can . I think that nerve damage can happen and be with you for ever . I wa about a year and have with the symptoms . Best to you.
I’ve enjoyed watching many of your videos and educating myself on what I may need,68 years old with mildly bulging discs and stenosis from arthritis,do you have any opinions on Ultrasonic techniques to free pinched nerves causing pain down arms and weakness and swelling in hand? I’m currently waiting to see my surgeon with my MRI
Ultrasound is a way of cutting bone that is no different than our traditional tools and have not been shown to have any difference in outcomes when clinically studied
Could you please do videos on spinal cord stimulators and SI joint pain? Thanks!
Yes
I have a patient with spinal cord broken, on the lower side of the spinal cord (lumber) where he is felling so much pain. I need help from you please.
Is there any chance you have a video of a Posterior Laminectomy with Fusion from C2 to C7? I will be going in for this soon. Also would you use any bridges?
Watch the video on posterior cervical fusion
Thank you Dr. Su. A question: do you have to cut through muscle to perform your surgeries (whether laminoplasty or the other surgical methods)? If not, how do you handle the muscles and if you do have to cut, how does it heal?
You don't cut through the muscle you split the muscle and they heal together
Still following you. Thank you for everything. Will be asking to be referred to a Spine Doctor soon. Just had my 4th shots in my back for Lumbar Spondylolisthesis with osteoporosis. Now with shots only having strange itchy tingling in the upper back between my shoulders. I would like to know if there us a good Doctor that you happen to know that you would suggest in Tulsa Oklahoma?
Unfortunately I don't know any doctors there.
@@DrBrianSuTheSpineGuy Is it possible to become your patient?
Giving thanks to Doctor Ani John is something I will always take personal because he brought me back to my full health he is a good man and trustworthy so kind to every patient,
contact Dr.Ani John on UA-cam channel now for help for Any kind of health issues.
Dr. Su,
Had Laminoplasty procedure performed approximately six years ago on C7 - C8. Currently, I’m presenting with increasing moderate to severe stenosis in the lateral canals @ C7-C8.
I didn’t hear in your presentation that this was a potential side effect issue. I’m curious to know what number of incidents and/or percentage of patients that have had Laminoplasty experience post surgery stenosis in the lateral canals where Laminoplasty had been performed?
Also, do you provide second opinions on results of or recommendation of procedures based upon radiological reports. If so, please advise.
Thank you,
Bob
Giving thanks to Doctor Ani John is something I will always take personal because he brought me back to my full health he is a good man and trustworthy so kind to every patient,
contact Dr.Ani John on UA-cam channel now for help for Any kind of health issues.
It is exceedingly unusual to get recurrent stenosis centrally. I would have to look at the CT and mri. You can make an appointment with me to look at the imaging at California orthopedics and spine
Would Facet arthropathy prevent a laminoplasty to be performed for multilevel cervical central stenosis and neural foraminal stenosis ? Also, your videos are very informative. Thank you
Some people think that facet arthropathy causes pain in a fusion tends to help that. Interestingly that has not really been born out in the literature so arthritis is not really a contraindication to this procedure
Thanks for your video's doctor. I have a reversed cervical lordotic curve and three protruding discs. I would like to ask you if this means i have a condition similar to adjacent segment disease in which i am more prone to additional disc pathology even without an operation?
People with a reverse curve are prone to more degeneration. You should try physical therapy to correct the posture
@@DrBrianSuTheSpineGuy Thanks doctor i am currently doing physiotherapy in a total of 12 sessions.
Hi Dr Su how are you? Can laminoplasty handle multi cervical levels I.E. from C3-C7 for example? What complications are there? Is true that people having laminoplasty can have more post operative pain than people operated with fusion? What are the qualifying factors to get a laminoplasty? IE age, bone strength etc.
How does laminoplasty perform throughout the years? Thank you.
That surgery is meant for multiple levels. Complications are in the video. As is recovery.
Doc, generally, what circumstances preclude the plasty and force the surgeon to the path of fusion?
I'm about to publish the episode on cervical fusion. You'll have to talk to your surgeon about it. In general if there is significant kyphosis I would not recommend a laminoplasty. Also if there is instability I would not recommend a laminoplasty. Lastly if they have to resect more than 50% of the facet joint to do a simultaneous foraminotomy then you have to do a fusion.
I have Stenosis...my arms stop working rite.
I was thinking bad things.
This is being done to me, you explained it so well...I have so much hope now
Thank you.
Do I understand correct that the cause of spinal cord compression (herniated disc) is not treated with a laminoplasty? What prevents the disc from herniating further and compressing the spinal cord again?
Thank you for sharing your knowledge and explaining it so clearly.
It depends on the imaging sometimes that's better treated with an anteriorly based procedure. You can call California orthopedics and spine for a virtual consult with me
My dad is being told that an ACDF is his best option for mod-severe central canal stenosis at C3-4 to arrest the myelopathy. I asked about the laminoplasty and the surgeon said the ACDF is less invasive and less painful for my 84 yr old dad. We’re from the Mid-atlantic region in PA. Any thoughts are appreciation.
I would have to take a look at the imaging. You can make a virtual appointment with me by calling California orthopedics and spine
I have a small disc herniation in C3-C4.Having numbness in my quads,with ambulation.No pain.Will this go away? MRI showed no signal,with no significant stenosis.The PA put me on medrol dose pack.Is this appropriate
That could be reasonable but I would have to look at the imaging. You can always make a virtual appointment with me at California orthopedics and spine
If this discs are degenerated and bone spurs above my previous fusion c4 and c5...i was told doing another fusion will make my nick stiff like Frankenstein so i need to do this kinda of surgery. I just wonder if those plates in this video will keep the bones from pressing down and further pressing into the discs
There is a risk of adjacent level disease of 1 to 3% per year
Can you tell me what office i contact to get an assessment with you? I have congenital myelopathy but am also kyphotic and am hoping i am still a laminoplasty candidate
You can make a virtual appointment with me at California orthopedics and spine
Dr. Su, do you know any neurosurgeons in Hawaii who do laminoplasty? Thanks
I'm not sure.
Dr, I had a C5-C6 ACDF after having sustained clonus, weakness on left side of body and numbness, balance issues. At age 33. It improved most of my symptoms but am left with numbness and balance instability
At age 35 I blew out the C6-C7 while working out and opted for a Centintel Pro-Disc C artificial disc replacement to preserve range of motion and this procedure was much easier and had great results!!
At 36, I just used a cerivcal traction device and the next day I had difficulty speaking properly, my vision was patchy and I couldn’t focus. Seems like my balance is worse and I am dragging my left foot every once in awhile. I am chalking it up to inflammation caused by the traction device.. but very concerning.
I have a slight C3-C4 compression anterior and posterior, and it looks like my C6 still has posterior contact with spinal cord but it’s hard to see due to artifact.
I have zero peripheral nerve pain, my symptoms are always neurological and spinal cord related.
Do you think I would be a good candidate for Laminoplasty?
I am 36, am a special ops law enforcement officer and have two young children.. I want to remain active as long as possible for my job and family. I’ve changed my diet and my workouts completely to eliminate further inflammation. I’d say my compression is a 4/10 but my doctors say my neuro symptoms are 8 or 9/10 and I need a fix asap.. I’m tired of getting such widely varied opinions from doctors and just want to get fixed.
I would have to look at the imaging and your symptoms. Please call 415-925-8200 for a second opinion virtual visit with me
Did you ever do a level 4 fusion?
Yes
Sir, my husband doesn't have extreme pain or symptoms. But his MRI on cervical spine shows significant spinal stenosis at c3 where canal area is 3.6 mm2 . And OPLL from c2 to c6. He is only 39 yr old. Is surgery needed? Could you please suggest what kind of surgery will be best for him. I am really very anxious. Hoping to get you reply.
I would have to look at the imaging studies you can call my office for a second opinion. 415-9258200.
I have classification that has frozen my neck 7 sectors My doctor said I should have the fusion as well. But he says I could also just do the other one I'm trying to weigh my odds On what the best decision is My right arm is already Frozen Do you have any advice for me?
Please call California orthopedics and spine for a virtual appointment with me
Found out today that I have to have C4-C7 Laminectomies & Foraminotomies. Do you think it’ll make the pain in my shoulder blades go away & the numbing of the whole left side of my trunk?
Yes taking the pressure off the nerve can often take the shoulder blade pain away because the shoulder blade pain is referred from the nerve. As a disclaimer please consult your surgeon.
@@DrBrianSuTheSpineGuy thank you so much Dr Su. I really enjoy your content.
I have spinal fusion in c6-t3 and after surgery i feel shoulder blade tingling and pain in my both hand. What is it Doc?
You should get evaluated by a surgeon.
Do you deal with Chiari malforamation as well? Or do you know chiari specialist youd reccommend? I am coming from Canada and am not having much luck
I would recommend finding a neurosurgeon
@@DrBrianSuTheSpineGuy yes I am looking for a neurosurgeon that specializes in Chiari
Why not ultrasonics
👌
🌹1:27
🌹2:25 Laminoplasty plate
🌹6:26 Benefits & risks
🌹9:36 JAMA 2022 研究比較1.前或後入路手術對避免C-myelopathy惡化何者長期效果為佳及2. Laminectomy+fusion VS Laminoplasty 何者為佳。
I was recommended to have either C4-C7 ACDF or Posterior laminoplasty due to canal reduction and possible myelopathy and I say possible bc I’m asymptomatic right now just some numbness in the morning but no other significant loos of function or pain. I have visited three neurosurgeons one just recommended ACDF, other don’t even considered surgery and the other suggested that I should considered it in a short term and asked me to research about it. I found your video very explanatory but reading about ACDFo or PL terrifies me, I’m a very active 57 y/o person, a dancer a speech therapist no sure if I should get into a surgery when I don’t show any myelopathy symptoms. Your opinion? Thanks
You should watch the video on cervical stenosis and when people need surgery for that. You can also make a virtual appointment with me by calling California orthopedics and spine
It is titled cervical stenosis how do I know if I need surgery?
Thank you so much I’ll watch the video to learn more
Couldn’t those plates come off in a future injury/accident and puncture the spinal cord? Also, is this procedure an option if you also have OPLL? Thank you!
Once the bony hinge side fuses the plates are not serving any function so they do not come apart. I would be careful about doing it in the presence of opl. Even though it was originally designed for that there are many studies that show the ongoing motion causes progression of opl so in that situation I usually recommend a fusion
@@DrBrianSuTheSpineGuyThank you for your response and explanation.
Hi doc, where are you located?
Marin California
Ddoctor, after the operation in t3 to t6, the numbness in my feet and hands disappeared. why now 4 months after the surgery, my feet and hands are numb again. is it normal? thank you for your answer
I need to see the MRI.
@@DrBrianSuTheSpineGuy I only had an X-ray after my operation. I had an MRI before my operation.
Hi, Just wanted to ask a question.
Is it normal to still have neck and shoulder swelling and pain 4 month post-op
It depends on the situation I would have to do a second opinion
@@DrBrianSuTheSpineGuy Thank you.
There is no hinges to hold the fracture side? How fast does the fracture side of the lamina fuse?
The fracture side heals over 3 months
@@DrBrianSuTheSpineGuy Thank you for your quick reply Dr. Su! stability is not an issue during the healing process?
Does this surgery causes head to fall forward over time?
Have you had patients who have had nausea and dizziness as a result of cervical myelopathy? It seems, based upon my research, that many individuals state those as issues they deal with due to cervical spinal stenosis. Thanks.
That's a rare symptom
@@DrBrianSuTheSpineGuyCould dizziness come from severe cervical foraminal stenosis at c3-c5?
Will numbness go away after cervical laminoplasty?
Numbness rarely gets better but it's not something that usually bothers people
I was recommended to have ACDF from c4 to 7. Would a cervical laminoplasty be a better option? Is laminoplasty only recommended for spinal cord compression?
That is difficult to tell without looking at the imaging you can make a virtual appointment with me at California orthopedics and spine
WHEN C3 TO C6 HAS BEEN OPERATED, WHAT WILL BE THE EFFECT
It depends what kind of operation
@@DrBrianSuTheSpineGuy lamino plasty
I’m getting this surgery in four weeks. I’m scared out of my mind, but also relieved that I potentially won’t be in this much pain anymore. I Swim several days a week. How long will it be until I can swim again? Even just simple breaststroke. Also at what point after surgery can I get up on my own to use the restroom? 😂
I would let my patient swim after 6 weeks
How did the surgery go?
@@wjh719 It went very well, thank you! I woke up from surgery and my arm pain was gone. I went home after a day and a half. I was pretty mobile after a few days and I’m doing great now. The muscles and nerves around the neck have to rebuild for some time, so I still get sore if I’m standing for too long. That continues to get better with time.
That is great. Good for you. Do you mind me asking what your symptoms were? Also what levels were treated? I am scheduled for surgery in 2 weeks. Nervous. I have some atypical symptoms like dizziness along with the tingling and numbness in arms and legs. Thanks.
@@wjh719 I had VERY painful nerve pain radiating down my left arm. I initially thought I had an impinged shoulder. I could never sleep the whole night through. As I got closer to surgery, my neck started to hurt too and got a lot weaker. I never had issues with balance, but I did experience tingling at times in my left hand. I had stenosis between C6 and C7 and my doctor thought it would be best to prevent further stenosis in the future because I had overall very narrow space in my cervical spine. Surgery is never fun, but I’m certain in the long run, you will probably feel MUCH better. Just be diligent with taking your pain meds and get lots of rest.
Help me out. If there's arthritis in C-3 C-4 C-5 & C-6.. could the laminoplasty still be done?
Yes