The primary aim of laminoplasty in multilevel stenosis is to:

• A. Preserve posterior elements and reduce risk of kyphosis
• B. Stabilize the anterior column
• C. Decompress only anteriorly
• D. Increase posterior tension

Answer: (A)

Laminoplasty is used to decompress the spinal cord while preserving the posterior elements of the spine, with the aim of maintaining the dorsal tension band to prevent deformity. In multilevel stenosis, removing the posterior structures with a laminectomy can destabilize the spine and let the neck drift into kyphosis because the posterior tension band is disrupted. Laminoplasty expands the canal by repositioning the laminae in a hinged fashion, enlarging the space for the cord but keeping the posterior elements and ligaments intact. This provides effective multilevel decompression without compromising stability, which is why preserving the posterior elements and reducing the risk of postoperative kyphosis is the best description of the primary aim. It’s a posterior approach for decompression, not an anterior stabilization, and it doesn’t rely on decompression from the front.