Spinal laminoplasty is a minimally invasive spinal surgery technique that is gaining popularity worldwide for treating cervical myelopathy and ossification of the posterior longitudinal ligament of the spine.
Rise of Minimally Invasive Spine Surgeries
Traditionally, spinal fusion surgeries involving opening the back and fusing vertebrae together were the standard procedures for treating various spinal conditions. However, these open spine surgeries are highly invasive, require long recovery periods, and often lead to adjacent level problems down the road. In recent years, there has been a noticeable shift towards less invasive techniques like spinal Global Spinal Laminoplasty that aim to preserve spinal function and mobility.
According to a report by Global Market Insights, the global spinal laminoplasty market size was valued at USD 400 million in 2018 and is expected to surpass $650 million by 2025 growing at a CAGR of over 6.5%. The growth is attributed to factors like rising geriatric population suffering from degenerative spine conditions, increasing demand for minimally invasive surgeries, and advantages of laminoplasty over spinal fusions. Countries across North America, Europe, Asia Pacific and Latin America are witnessing increased adoption of laminoplasty.
How is Laminoplasty Different?
In a traditional laminoplasty procedure, the lamina or back portion of the vertebrae is opened or split on one side using specialized instrumentation but is not removed. Small bone graft material or ceramic spacers are inserted to maintain the opened spinal canal. This simple maneuver allows the spinal cord and nerve roots room without the extensive bone removal and stabilization required in spinal fusions.
The procedure works on the philosophy of not closing or fusing the spinal canal but leaving it open or exposed after surgery. This preserves spinal movement and helps reduce complications like adjacent level issues witnessed with fusions. Laminoplasty is ideal for cervical myelopathy where just creating more space is required without compromising stability. It has advantages like shorter hospital stays, quicker recovery times, and maintains spinal functions compared to rigid fusions.
Global Procedural Growth
Asian countries like Japan, South Korea and China have been at the forefront of laminoplasty developments since the 1980s. In Japan alone, over 150,000 cervical laminoplasty procedures are performed annually for cervical spondylotic myelopathy according to government data. Additional Asian markets are also reporting higher procedural volumes compared to Western nations.
However, laminoplasty is fast gaining acceptance in the United States, United Kingdom and other European countries asNeurosurgeons become more familiar with its techniques and advantages. The American Association of Neurological Surgeons now considers laminoplasty an important treatment option for cervical myelopathy and OPLL. Professional training programs are fueling its adoption. Private insurers are also covering the procedure recognizing its benefits over fusions. Countries like India and Brazil are emerging laminoplasty hotspots in other regions.
Standardization of Surgical Techniques
Early laminoplasty approaches varied widely between surgeons with inconsistent outcomes. Extensive research and experience over the last two decades have led to standardization of key technical aspects. Commonly used techniques include the French door, midline-split, and double-door laminoplasty methods. Instrumentation sets from major medtech firms help standardize flap creation and stabilization.
Selection of alloplastic spacers or miniplates for flap fixation provides stabilization without rigid fusions. Studies show inter-laminar spacers like hydroxyapatite implants provide stability equivalent to miniplates with less risk of neurologic complications. Operative times have reduced to 1-2 hours on average as Neuorsurgeons master these standardized techniques.
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