Indications
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Multilevel cervical stenosis with preservation of normal lordotic curvature
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Diffuse ossification of posterior longitudinal ligament
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Posterior cord compression resulting from buckling of thickened ligamentum flavum
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Posterior exposure of intraspinal pathology, including tumor, vascular malformation, infection, and hematoma
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Factors limiting anterior neck dissection, including short neck, scarring from previous anterior neck dissection or radiation.
Planning and positioning
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Baseline motor evoked potentials and somatosensory evoked potentials are obtained before patient positioning.
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The patient’s head is secured in a Mayfield head holder.
Figure 61-1:
The patient is positioned prone with chest rolls, and a Mayfield head holder is fixed to the table with the head and neck slightly flexed.
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The patient’s arms are tucked at the side and carefully padded at the axilla, elbow, and wrist.
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A midline skin incision if marked using palpation to identify the spinous processes. Generally, the spinous processes of C2 and C7 tend to be most prominent and easily palpated.
Procedure
Laminoplasty
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