This video explains Cervical Stenosis and Cervical Spondylosis/Arthritis. When stenosis begins to affect the spinal cord this is called Cervical Spondylotic Myelopathy. This video highlights the history, epidemiology, and treatment options both conservative and surgical. If you or someone you know needs to be seen in regards to Cervical Stenosis/Arthritis for a Laminoplasty feel free to look us up online www.beverlyspine.com or www.santamonicaspine.com OR call toll free 1-8SPINECAL-1

1. Pablo Pazmi ño, MD

11. Three distinct clinical syndromes can result: Type I: Cervical Radiculopathy: Cmprsn +Inflammation of Spinal Nerve with symptoms that correspond to the level involved Type II: Cervical Myelopathy: Cord involvement Type III: Axial Joint Pain (Mechanical neck pain, “discogenic pain”, facet syndrome, painful instability

19. Here is what I mean by a foundation concept. You will see side view images and top down images throughout this presentation and on your MRIs. This can be hard to grasp unless we stop and point a few things out initially The Sagittal view is also called the lateral view and this is pictured here it displays the spine as viewed from the SIDE. The Axial view is a top down view of the spine. This image repsents a slice obtained as if an Axe were to chop you, therefore the name Axial view.

28. Joint Facet Nucleus Pulposus Right Nerve Root Left Nerve Root As you can see here on MRI and CT scans the Facet joints end up looking like the buns of a hamburger. Its just the way the happen to look when they are sliced in this plane. We will show you this on some examples later Annulus Fibrosus Axial View of the Disc and Neural elements Spinal Cord

29. Joint Facet Disc Right Nerve Root Left Nerve Root Axial View

31. Joint Facet Disc Right Nerve Root Left Nerve Root Next I will show you some MRIs You will see this is a patient with a left sided herniation pinching off her exiting left nerve root Spinal Cord

32. Joint Facet Disc Right Nerve Root Left Nerve Root Axial Scans: Spinal Cord

33. Cervical 7 Spinous Process Nerves 2-3 Disc 3-4 Disc 4-5 Disc 5-6 Disc 6-7 Disc

38. Joint Facet Disc Right Nerve Root Left Nerve Root This is an Axial view of a normal space around the spinal cord. Notice how much room the Cord has Spinal Cord

39. Joint Facet Disc Right Nerve Root Left Nerve Root This is an Axial view of a normal space around the spinal cord. Notice how much room the Cord has

40. Joint Facet Disc Right Nerve Root Left Nerve Root This is an Axial view of the decreased space around the spinal cord with CSM. Notice how it is now triangular in shape

41. Joint Facet Disc Right Nerve Root Left Nerve Root This is an Axial view of the decreased space around the spinal cord with CSM. Notice how it is now triangular in shape and the Spinal cord looks like a bean

42. Joint Facet Disc Right Nerve Root Left Nerve Root The Laminoplasty seeks to increase the area around the spinal cord here and give the nerves an environment to heal

43. Joint Facet Disc Right Nerve Root Left Nerve Root The way Dr Pazmino performs this is by literally “hinging open “ the bone in the back of the neck called the Lamina Hinge open Here

44. Joint Facet Disc Right Nerve Root Left Nerve Root The way Dr Pazmino performs this is by literally “hinging open “ the bone in the back of the neck called the Lamina Hinge open Here

45. Joint Facet Disc Right Nerve Root Left Nerve Root To keep this hinge open a plate and a piece of bone is placed inside the Hinge to keep this open. This is a Laminoplasty Keep the Hinge open Bone

46. Joint Facet Disc Right Nerve Root Left Nerve Root Small screws are placed into the Lamina and the Lateral masses to keep the Hinge open. This is a Laminoplasty Keep the Hinge open Bone

47. Joint Facet Disc Right Nerve Root Left Nerve Root Now the SPINAL CORD has an environment where it can heal Bone

48. Joint Facet Disc Right Nerve Root Left Nerve Root Now the SPINAL CORD has an environment where it can heal Bone