For multilevel cervical myelopathy with posterior compression, which decompression procedure is commonly used?

• A. Posterior Laminectomy
• B. Foraminotomy
• C. Laminoplasty
• D. Anterior discectomy

Answer: (C)

Relieving posteriorly based compression across multiple cervical levels is best done by enlarging the spinal canal from the back while preserving the back structures. Laminoplasty accomplishes this by creating a hinged opening in the lamina and expanding the canal, effectively increasing space for the spinal cord across several levels. This approach decompresses the cord without removing the posterior tension band, helping maintain stability and reducing the risk of postoperative deformity or instability that can follow extensive laminectomy. It also avoids the need for long fusion, preserving more natural motion. By contrast, a posterior laminectomy alone can predispose to instability and kyphosis after multilevel disease, foraminotomy targets foraminal (lateral) compression rather than central posterior compression, and anterior discectomy treats ventral pathology rather than posterior compression across multiple levels.