A cervical laminectomy Surgery is an operation done from the back of the neck to relieve pressure on the spinal cord and nerves. It involves carefully removing the bony roof (or laminae) of the spinal canal, as well as any soft tissue which may also be causing compression. Spinal stenosis is the gradual narrowing of the spinal canal, usually caused by arthritis, bone spurs, or the general wear and tear on the spine that occurs over time.
A cervical laminectomy Surgery creates more space in the canal for the spinal cord and nerve roots, releasing the pressure and eliminating discomfort and numbness. Generally, 90-95% of patients obtains a significant benefit from surgery, and this is usually maintained in the long term.
Patients who have cervical stenosis are potential candidates for this surgery. Spinal stenosis occurs when the spinal canal narrows, putting pressure on nerve roots and the spinal cord. This surgery relieves this pressure by removing a section of bone from the rear of one or more vertebrae.
Other conditions that can put pressure on the nerve roots or spinal cord include:
Cervical spine surgery may be needed for a variety of problems. Most commonly, this type of surgery is performed for degenerative disorders.
A CERVICAL LAMINECTOMY IS USUALLY PERFORMED FOR ONE OR MORE OF THE FOLLOWING REASONS:
Surgery is usually recommended when all reasonable conservative measures (pain medications, nerve sheath injections, physical therapies etc.) have failed. In cases of significant instability or neurological problems, surgery may be the most appropriate first treatment option.
Many people older than age 50 have some narrowing of spinal canal but not symptoms. Cervical spinal stenosis does not cause symptoms unless spinal cord or nerves becomes squeezed. Symptoms usually develop gradually:
Generally, surgery is fairly safe and major complications are uncommon. The chance of a minor complication is around 3 or 4%, and the risk of a major complication is 1 or 2%. Over 90% of patients should come through their surgery without complications.
THE SPECIFIC RISKS INCLUDE (BUT ARE NOT LIMITED TO):
A general anaesthetic will be administered to put you to sleep. A breathing tube (‘endotracheal tube’) will be inserted and intravenous antibiotics and steroids injected (to prevent infection and post-operative nausea). Calf compression devices will be used throughout surgery to minimise the risk of developing blood clots in your legs.
Your skin will be cleaned with antiseptic solution and some local anaesthetic will be injected.
The skin incision is about 5-7cm down the back of your neck. It is vertical and in the midline. The muscles at the back of the neck are gently separated from the spinal bones, and the bony roof over the spinal cord is carefully removed using small drills and other fine instruments. Any soft tissue causing compression is also removed.
The spinal cord is decompressed once the bone and other tissues have been removed and discarded. Each nerve root (when appropriate) is identified and carefully decompressed (this is known as a ‘rhizolysis’).
In some cases, instrumentation (rods and screws) will also be used to add stability to the spine. This is known as a lateral mass fusion, and generally does not require bone to be taken from the hip (the bone removed from the back of the spine can be used in this case).
Another X-ray is performed to confirm satisfactory cage, plate and screw positioning, as well as cervical spine alignment.
The wound is closed with sutures and staples. In some cases a wound drain may be used for 24-48 hours post-operatively.
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