Cervical spineMinimally invasive surgery

Expansive cervical laminoplasty

Expansive cervical laminoplasty is considered for patients with neck pain, stiffness and arm or hand symptoms from cervical stenosis compressing the spinal cord. When medication, physiotherapy or injections are no longer sufficient, it allows wide canal decompression. The procedure opens the laminae through a posterior approach, creating a “door” that is fixed in a wider position with plates or sutures to give the cord more space while aiming to preserve stability and some motion. Indication is personalised after neurological examination and imaging, weighing expected benefits, recovery and risks before deciding.

Spine neurosurgeon in Alicante and Benidorm

More than 20 years of experience in Neurosurgery (since 2003)

Vithas Medimar Hospital Alicante and Hospital Clínica Benidorm

Illustrated schematic of cervical laminoplasty to widen the spinal canal.

What is expansive cervical laminoplasty?

Expansive cervical laminoplasty is a surgical technique in which the back part of the cervical spinal canal (the laminae) is opened and “expanded” to create more space for the spinal cord without completely removing the bone. Controlled cuts are made to create a “door” that is fixed in a wider position, usually with small plates or sutures, so the canal enlarges. This procedure acts on the posterior laminae and spinal canal without fully removing the back of the vertebra. The goal is to decompress the spinal cord when diffuse compression is caused by arthritis, ossification or multilevel stenosis. Unlike techniques such as simple laminectomy or some posterior fusions, expansive cervical laminoplasty aims to preserve stability and some motion, reducing the risk of deformity over time in selected patients.

Symptoms and warning signs

Patients who may benefit from expansive cervical laminoplasty often show signs of cervical myelopathy and sometimes radiculopathy. It is important to pay attention to:

Chronic neck pain, sometimes radiating to shoulders and arms

Tingling, numbness or “electric shock” sensations in hands and fingers

Clumsiness with fine motor tasks such as buttoning clothes, writing or using cutlery

Unsteady gait, imbalance or unexplained falls

Red flags: sudden or progressive loss of strength, marked difficulty walking, frequent falls, bowel or bladder changes or rapid worsening of symptoms

When is this procedure indicated?

Persistent neck and neurological symptoms despite adequate conservative treatment (medication, physiotherapy, posture measures)

MRI or CT showing multilevel cervical stenosis with spinal cord compression

Neurological progression: worsening weakness, hand clumsiness, gait disturbance or clear signs of cervical myelopathy

Pain and functional limitation significantly affecting quality of life and independence

Cases where wide posterior decompression is needed while preserving some stability and motion as an alternative to other techniques

How is the procedure performed?

1.Preoperative preparation

Before expansive cervical laminoplasty, a thorough clinical assessment is performed, focusing on neurological examination and balance. Imaging studies are reviewed in detail to define the levels to treat. The neurosurgeon explains the goal of surgery, the technique, expected benefits and potential risks, answering all patient questions. Fasting instructions are given, medication is reviewed (especially blood thinners or antiplatelets) and hospital admission is organised. Once everything is clarified, informed consent is signed.

2.During the procedure

Expansive cervical laminoplasty is performed under general anaesthesia through a posterior approach. Muscles are separated to expose the laminae of the cervical vertebrae to be treated. Controlled cuts create a “door” that opens to one side, enlarging the spinal canal. The laminae are fixed in their wider position using small plates, screws or special sutures so the canal remains expanded and the cord has more space. Decompression is checked and the wound is closed in layers.

3.Immediate postoperative period

After surgery, the patient spends time in recovery to monitor awakening from anaesthesia, breathing and pain control. Then they return to the ward, where progressive mobilisation usually starts the next day. Strength, sensation, gait and neck pain are closely monitored. Hospital stay typically lasts 2–3 days, adjusted to each patient’s progress.

Recovery and daily life

In the first days after expansive cervical laminoplasty, neck pain, stiffness and fatigue are common. Basic mobilisation (getting up, short walks, personal hygiene) usually begins early. Returning to office work is often considered between 4 and 6 weeks if recovery is favourable. For physical jobs involving lifting or forced neck postures, recovery is typically 8–12 weeks or more depending on individual response and job demands. Physiotherapy, gait retraining, progressive strengthening of cervical and dorsal muscles, and ergonomic habits are essential. If fever, intense pain that does not improve, new weakness, worsening gait or any alarm symptom appears, contact the specialist for reassessment.

Risks and possible complications

As with any spine surgery, expansive cervical laminoplasty carries risks, although most patients recover satisfactorily. Knowing them helps make a balanced decision. General risks include anaesthesia-related problems, wound infection, bleeding, haematoma formation and venous thrombosis. Specific risks include nerve root or spinal cord injury, persistent cervical muscle pain, lack of neurological improvement, insufficient canal widening, displacement or failure of fixation material and changes in cervical alignment. Some patients may also experience shoulder or neck discomfort related to posterior muscles. Although uncommon, these risks must be weighed against the severity of stenosis and the patient’s symptoms. The decision is always individual.

Frequently asked questions

It usually takes between 2 and 3 hours, depending on the number of levels treated and case complexity. Additional time is needed for operating room preparation and the initial recovery phase. Your team will provide an approximate duration for your situation.

You will not feel pain during surgery because it is performed under general anaesthesia. In the following days, neck and posterior muscle discomfort is common but generally well controlled with pain medication. Many patients notice gradual relief of neck pressure and arm or hand symptoms as the cord has more space.

For office-based jobs, return is often considered between 4 and 6 weeks if recovery is favourable. Jobs involving lifting, repetitive movements or forced neck postures may require 8–12 weeks or more. The final timing is decided during follow-up visits.

Gentle activities like walking are encouraged early, with gradual increases in time and distance. High-impact or contact sports and activities requiring wide neck movements are usually reintroduced from around 3 months, depending on recovery and the advice of your surgeon and physiotherapist.

The goal is wide cord decompression, so recurrence of the same stenosis at treated levels is unlikely. Other segments may degenerate over time, and some patients may retain some pain or stiffness. Posture, muscle strength and habits strongly influence long-term outcomes.

Laminectomy removes the lamina completely, while laminoplasty opens and fixes them in a wider position to preserve more posterior structure. Compared with fusion, which stiffens segments and reduces motion, laminoplasty aims to maintain more motion in selected patients. The choice depends on stenosis pattern and cervical alignment.

Not necessarily. It is a good option for certain stenosis patterns and alignment, but fusion or combined approaches may be preferable in other cases. The decision is based on imaging, clinical findings and patient characteristics individually.

Do these symptoms sound familiar?

If you recognise yourself in some of these symptoms and your pain is starting to limit your daily life, we can review your case in a personalised consultation. Dr. Ben Ghezala will assess your clinical history and imaging studies to help you decide the best treatment option for you.

Request a consultation with Dr. Ben Ghezala