In individuals with cervical spine injury who do not appear to have significant instability, the surgeon may choose to perform an expansile laminoplasty instead of a laminectomy. This surgical option has been proposed for individuals with pre-existing cervical stenosis and who may have central cord syndrome after trauma. However, the procedure is far more commonly used in the treatment of chronic cervical myelopathy and especially for individuals with ossification of the posterior longitudinal ligament.
Various surgical techniques have been proposed for decompressing the injured spine. As discussed previously, the most common approach is to perform a laminectomy; however, in the cervical spine, another option is to perform a laminoplasty. This technique usually relies upon bone fragments or plate implants to mobilize the spinous processes and thus expand the spinal canal. Various groups have shown that in the appropriately selected individual population, laminoplasty is a reasonable alternative to laminectomy. There are no studies that compare similar subsets of patients undergoing laminoplasty or conservative management. There are no good studies comparing laminectomy to laminoplasty in patients with acute SCI.