Microsurgical Cervical Laminoplasty

Microsurgical Cervical Laminoplasty is a motion-preserving surgery performed to relieve spinal cord compression in the neck (cervical spine) caused by conditions such as cervical myelopathy or severe spinal stenosis.

Instead of removing part of the spine entirely (as in a laminectomy), this procedure reshapes and repositions the lamina — the bony arch covering the spinal cord — to create more space for the spinal cord and nerves, while maintaining stability and movement.

Using advanced microsurgical techniques, Dr. Tristan Fried performs this procedure through small incisions, preserving as much of the natural anatomy as possible.

Microsurgical cervical laminoplasty is commonly used for patients with:

• Cervical myelopathy (spinal cord compression)
   
• Cervical spinal stenosis from arthritis, bone spurs, or thickened ligaments
   
• Multilevel nerve or cord compression that cannot be addressed with a single-level procedure
   
• Degenerative changes causing progressive weakness, numbness, or coordination problems
   

• Laminoplasty preserves natural motion by expanding the spinal canal without fusing the vertebrae together.
   
• Laminectomy with fusion removes bone and stabilizes the spine with rods and screws, which eliminates motion at those levels.
   
• Microsurgical laminoplasty uses smaller incisions reducing tissue disruption and recovery time.
   
• Best suited for multilevel compression without significant instability.
   

Key benefit: Laminoplasty is a motion-sparing alternative, making it ideal for younger or active patients and those wishing to avoid a fusion.
 

You may be a candidate if you have:

• Neck pain and stiffness with progressive neurological symptoms
   
• Numbness, tingling, or weakness in the arms or hands
   
• Loss of coordination or balance, difficulty with fine motor skills
   
• Imaging showing multilevel spinal cord compression
   
• No significant instability that would require fusion instead
   

Patients with severe deformity or instability may need a different procedure, such as posterior cervical fusion.

• Small incision: A precise incision is made in the back of the neck.
   
• Bone reshaping: The lamina is carefully cut and lifted like a “door” to enlarge the spinal canal.
   
• Stabilization: Small plates or bone spacers are used to keep the lamina in its new position, relieving pressure on the spinal cord.
   
• Closure: The muscles and skin are gently closed with minimal tissue disruption.
   

• Preserves natural spinal motion – no fusion required
   
• Relieves pressure on the spinal cord and nerves
   
• Smaller incision with minimal muscle damage
   
• Outpatient or short hospital stay – many patients go home within 1–2 days
   
• Faster recovery compared to traditional open techniques
   
• Lower risk of adjacent segment disease than fusion surgery
   
• Can address multiple levels of compression in a single procedure
   

• Hospital stay:  Typically 1–2 nights, depending on the complexity and number of levels treated.
   
• Walking: Encouraged within 24 hours of surgery to promote healing and reduce complications.
   
• Return to light activity: Many patients return to desk work or gentle daily tasks within 2–4 weeks.
   
• Physical therapy: Typically begins 6 weeks after surgery to restore strength and range of motion.
   
• Full recovery: Most patients achieve full activity by 8–12 weeks, though neurological improvements may continue for months.
   

Many patients notice improvement in hand function, balance, and coordination within days to weeks as spinal cord pressure is relieved.

• Stop certain medications such as blood thinners, as directed by Dr. Fried.
   
• Avoid eating or drinking for a set period before surgery.
   
• Arrange transportation home since this is an outpatient procedure.
   
• Prepare a comfortable recovery area at home with essentials within easy reach.
   
• Quit smoking if possible, as it improves healing and reduces complications.

Contact Dr. Fried’s office immediately if you experience:

• Fever, chills, or redness at the incision site
   
• New or worsening weakness, numbness, or balance problems
   
• Severe neck pain that doesn’t improve with medication
   
• Sudden bladder or bowel control changes (medical emergency)