Laminoplasty is done by reconstructing the laminar arch in order to increase the space for the spinal cord in order to reduce the pressure on the spinal nerves. Dr Khumalo may perform laminoplasty to treat spinal stenosis in the neck or low back or as a method of accessing and treating spinal tumors (or syringomyelia) or a spinal cord cyst.
Under general anaesthesia, specialised monitoring machines are used to ensure the spinal cord's functioning and responsiveness while performing surgery. This surgery is often referred to as "open-door" laminoplasty. Unlike laminectomies where the lamina is removed, through an incision made in the spine, the lamina is partially cut on both the right and left sides. By doing this, Dr Khumalo is able to create a door-like structure with a hinge on one side. This "door" is then wedged partially open to provide more space within the spinal canal relieving pressure. In some cases, screws and tiny metal implants may be used to secure these wedges to keep them in place. Finally, before closing, any bone spurs or other sources of compression are removed.
Although this is regarded as an invasive surgery, your spine will be stable immediately after surgery. You will be asked to get out of bed and begin walking as soon as one day after surgery to improve mobility. Dr Khumalo will prescribe you pain medications to relieve any pain and discomfort. These medications may inhibit the function of your bladder, and thus a catheter may be needed for the first two days after surgery. You should be able to go home after a day or two.
Physiotherapy will be advised to help regain strength and mobility for the next few months. During recovery, you may be as active as your pain allows you, but you will be advised to avoid heavy lifting, vigorous exercise as well as twisting and bending for at least 6 weeks. You may return to work after 4 weeks of recovery.
Because those who have this surgery usually have multiple areas of pressure or compression, patients often have had issues with nerves including pain in the arms, numbness, difficulty using their hands normally, and balance problems. After laminoplasty, decompression should occur and within the next 6 – 18 months, nerve function should return.