Treatments

Cervical Laminectomy

Introduction

Your surgeon will determine the type of surgery recommended for you depending on your MRI scan. If the spinal cord is being compressed from the back of the spinal cord, then a posterior laminectomy surgery (from the back of the neck) is needed.

Description

.Posterior cervical laminectomy is a surgical procedure designed to relieve pressure on the spinal cord caused by degenerative changes in the cervical spine. In a laminectomy surgery, a three- to four-inch vertical incision is made in the midline of the back of the neck. The surgeon will remove the bones at the back of the vertebrae which are the spinous processes and the lamina. Often, there are multiple levels of laminectomy, the number of which is determined by your surgeon. With the lamina and spinous process removed, the spinal cord has more room (decompressed.).

In most cases, a spinal fusion may be performed after the laminectomy. Two or more of the affected vertebrae are joined together into a single unit using a bone graft and titanium screws with connecting rods.

The muscles of the neck protect the spinal cord once the incision is closed.

Goals

For myelopathy: to remove the bony compression (decompress) the spinal cord to prevent your myelopathic symptoms from getting worse. 

For cervical stenosis:  to decompress the spinal cord so as to avoid spinal cord injury and/or to prevent myelopathic symptoms.

 Any neck surgery may not relieve neck pain and likely will not have any significant improvement of neuropathic pain.

After surgery

  • You will be admitted to the hospital for 1-3 days

  • You may have a surgical drain in place after surgery.

  • You will be required to wear a neck collar for up to 12 weeks

  • You will have x-rays after surgery

  • You will be seen by a Physiotherapist and an Occupational Therapist before discharge home.

Complications

As with any surgery, there are a number of potential risks and complications of cervical laminectomy surgery. Your surgeon will discuss the general risks of any operation and the specific risks related to your particular surgery.

  • General surgical risks of general anesthetic such as heart attack, pneumonia or stroke.

  • Specific risks with spinal surgery include infection, bleeding or CSF leak any of which could require a repeat surgery.

  • Specific risk of nerve root injury that could result in transient or permanent weakness, numbness or pain in right or left arm. There is a rare risk of spinal cord injury.

  • Specific risk of hardware problems or failed fusion.

  • Specific risk of blood vessel injury that could result in stroke or death.

Recovery

Generally speaking, recovering after your surgery can take several weeks up to 3 months.

Return to Work: Talk to your surgeon about your expected time off work, about your ability to return to work and if there are any restrictions during your recovery time.

Recovery after myelopathy surgery: It is difficult to predict what degree of recovery (if any) to expect after surgery. Any potential neurological recovery (such as improved strength, improved balance, and/or change in sensation) can occur up to approximately 18 months.