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Laminoplasty vs. Anterior Cervical Discectomy and Fusion

RoperCORRoperCO Posts: 1
edited 05/02/2015 - 10:36 PM in Back Surgery and Neck Surgery
I am a 47 yr old female recently diagnosed with degenerative disc disease and cervical spinal stenosis with myelopathy and radiculation. The symptoms came on suddenly March 26, 2015. My MRI shows the stenosis is congenital with my "normal" measured at 10mm and compressed at the C4-C6 at the 6mm range and the C5 at 5.7mm.

One Dr. I went to wants to do ACDF 3 level surgery. He wants to do surgery ASAP saying that since we are in the 2 month window to fix this we have the highest percentages to regain the muscle loss and feeling loss.

My 2nd opinion Dr. wants to do C2-C7 laminoplasty and agrees sooner is better but there is no magic 2 month window.

I don't know which way to go. I have read over the information on the website about each procedure and read many posts about each surgery, good and bad. Thoughts, ideas, opinions are welcome!

Nobody on the forum is medically qualified or permitted to give advice any responses will be based on members personal experiences


  • LizLiz Posts: 9,760
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    Spinal stenosis since 1995
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    Cervical stenosis, so far avoided surgery
  • That's a huge difference in opinions. Honestly, I'd get a third opinion. Having and ACDF myself, and one surgeon initially gave the option of posterior, I learned that it's reserved mostly for older people, 4 levels or more, and if the compression is on the posterior portion of the cord.
    From what I've read, the window is definitely less than 1 year, and preferably before 6 months of being symptomatic. You have moderate compression, so I certainly wouldn't wait too long.
    Good luck!

    ACDF w/Corpectomy C3-6 12/8/14 ; Laminectomy C3-6  5/19/2016

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  • I read your post and I think you are right now where I was about 2 years ago. Same age, exact same diagnosis...etc.
    (Cervical spinal stenosis caused by a congenial narrow spinal canal and degenerative disc disease and radiculopathy)

    Just like you I went to a few different specialists (btw. I m a physician myself, but not an orthopedic surgeon) and I also got different recommendations on what the best surgical approach would be. After a few month of researching a lot of literature I came to the conclusion that a posterior approach (Laminoplasty) would be the better approach in my case because it actually addresses the cause (which is a congenital narrow canal) better than an ACDF from anterior and would leave most of the biomechanics of my cervical spine intact.

    I was also told that I need immediate surgery back then until I met a orthopedic surgeon who also recommended Laminoplasty to me but also explained to me that he doesn't think that surgery is necessary yet. Back then I had serious deltoid weakness (I couldn't really lift my arm) but he told me that mostly likely this would resolve my itself, and it really did.

    Of course I still have spinal stenosis and DDD and I m sure at one point I will need surgery but with this kind of surgery you
    want to be sure that its really indicated. Every case is different and it depends on the severity of the symptoms to decide whether you need surgery now or not and if I were you I would probably consult with a physician who does not profit from a surgery himself and get more of an independant opinion....i.e. from a neurologist.
    But what kind of myelopathic/ radicular symptoms do you currently have ?
  • I am somewhat older than you [58 y/o male]-if that makes a difference. My orthopedist is recommending a 3 level fusion as a result of cervical spinal stenosis as well as nerve root impingement. I am in the process of getting a second opinion and will then get a third. My understanding is that over all instability of the spine is a factor as is the source of the compression-in my case I have herniated discs which are compressing the anterior aspect of the chord. Some of the articles I have read talk about a slower and more painful recovery, bleeding and scar tissue with the posterior approach. Bottom line is really grill each doctor why they feel that this is the best approach for you, and then get a third opinion if you feel its appropriate. You should then be in a better position to make the call -either that or confused as hell. Preserving range of motion is great, but not if its not a long term solution to the problem.
  • I'm a 75-year old male in fairly good health. I'm diagnosed with multilevel cervical spondylosis with myelopathy and multilevel foraminal narrowing, so I have impingement on both the spinal column and nerve roots. I was diagnosed via MRI in 5/2013, again in 05/2015. C3 through C6 are involved and the impingement is both anterior and posterior, and has progressed moderately since 2013. I also have anterolisthesis C7 on T1. Hmm.. how can I still be on my feet?

    An orthopaedic surgeon at an independent orthopaedic clinic who was a resident and fellow in neurosurgery recommends ACDF at those 3 levels. A neurologist at a major teaching university recommends laminoplasty at those levels (does 11 laminoplasties per year).

    I'm struggling with the decision, although I favor laminoplasty. Can anyone share a similar experience?

    11/13/2015 - update: Since no one has responded, I'm following up to report that my neurosurgeon recommends - and I've decided on - multilevel laminoplasty. I'm concerned about the potential for post-op adhesions. Does anyone have personal experience with adhesions following laminoplasty... or, for that matter, laminectomy?
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  • SavageSavage United StatesPosts: 7,385
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  • SukhreSSukhre San Diego, CAPosts: 205
    edited 03/01/2016 - 8:24 PM

    I have the same question as well ACDF vs laminoplasty.

    In my case I have small disc bulges. I have a narrow spinal canal. So ACDF would take off the bad disc and decompress (hopefully). lLaminoplasty would open the spinal canal  in the back and the spinal cord will get space in the back to compress.

    It would be interesting to know any data that compares laminoplasty with ACDF. I would need a laminoplasty of C4-C7 or ACDF of C4-6.

    What I read that ACDF has higher rate of reoperations and Laminoplasty recovery is harder (it also associated with more C5 palsies and kyphosis). It would be interesting to read laminoplasty patient feedback or any data comparing ACDF to laminoplasty

    MRI shows C4-C7 severe steonosis. Pain in hand.
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