Laminoplasty: A review of the evidence and detailed technical guide

Laminoplasty represents a powerful motion-preserving technique for the treatment of multilevel cervical stenosis. Laminoplasty has a significantly lower complication rate than multilevel anterior procedures, and if the anatomy is favorable for dorsal decompression, it provides a reliable outcome and high rate of neurologic recovery. The model laminoplasty patient would have multilevel stenosis, minimal or secondary axial complaints, and lordotic sagittal alignment and is ideally k-line positive and has a less than 50% ventral occupation ratio. There are a multitude of technical considerations when performing laminoplasty in order to optimize outcomes. Maintaining the extensor musculature, particularly at the C2 and C7 attachments, is paramount for avoiding postoperative kyphosis and minimizing postoperative neck pain. Despite the large expanding body of evidence and proven utility of laminoplasty, there continues to be significant regional variability in the utilization of this valuable technique.