High-Quality Best Cervical Laminectomy Surgery Cost In India
What Is Cervical Laminectomy Surgery?
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.
Who needs Cervical Laminectomy?
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:
- Degenerative discs
- Bone spurs
- Calcium deposits
- Tumors
- Bony fragments from a fracture or infection
Why May I Need A Cervical Laminectomy?
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:
- To treat pressure on the spinal cord (caused by cervical canal stenosis/spondylosis or an intervertebral disc prolapse).
- To treat pressure on multiple spinal nerves in the neck (caused by foraminal stenosis, cervical spondylosis, or an intervertebral disc prolapse)
- To treat instability of the cervical spine (this may occur due to degenerative changes, arthritis, or trauma). In this situation, a fusion using lateral mass screws is performed to stabilise the spine as well as taking pressure of the spinal cord.
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.
Symptoms Of cervical laminectomy Surgery
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:
- Stiffness, pain, numbness, or weakness in the neck, shoulders, arms, hands, or legs.
- Balance and coordination problems, such as shuffling or tripping while walking. Cervical spinal stenosis can be crippling if the spinal cord is damaged.
- Loss of bowel or bladder control (incontinence).
Imaging tests cervical laminectomy surgery
- X-rays. An X-ray of your back can reveal bony changes, such as bone spurs that may be narrowing the space within the spinal canal. Each X-ray involves a small exposure to radiation.
- Magnetic resonance imaging (MRI). An MRI uses a powerful magnet and radio waves to produce cross-sectional images of your spine. The test can detect damage to your disks and ligaments, as well as the presence of tumors. Most important, it can show where the nerves in the spinal cord are being pressured.
- CT or CT myelogram. If you can’t have an MRI, your doctor may recommend computerized tomography (CT), a test that combines X-ray images taken from many different angles to produce detailed, cross-sectional images of your body. In a CT myelogram, the CT scan is conducted after a contrast dye is injected. The dye outlines the spinal cord and nerves, and it can reveal herniated disks, bone spurs and tumors.
Risks cervical laminectomy surgery
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):
- Fail to benefit symptoms or to prevent deterioration
- Worsening of pain/weakness/numbness
- Infection
- Blood clot in wound requiring urgent surgery to relieve pressure
- Cerebrospinal fluid (CSF) leak
- Surgery at incorrect level (this is rare, as X-rays are used during surgery to confirm the level)
- Blood transfusion
- Implant failure, movement, or malposition (when a fusion is also done)
- Recurrent disc prolapse or nerve compression
- Nerve damage (weakness, numbness, pain) occurs in less than 1%
- Quadriplegia (paralysed arms and legs)
- Incontinence (loss of bowel/bladder control)
- Impotence (loss of erections)
- Chronic pain
- Instability or forward collapse of the neck (kyphosis) (may require further surgery)
- Stroke (loss of movement, speech etc)
before the procedure:
- In the weeks prior to your surgery, pre-operative testing will be conducted either by your primary care physician or the pre-admission testing department of the hospital.
- One week prior to surgery, you will need to stop taking aspirin, NSAIDs or other medications that thin your blood and may increase bleeding.
- If you smoke, it is important you stop well before surgery and avoid smoking for a period of at least 6 months afterwards, as this will impede proper healing.
- You will be given instructions and supplies to cleanse the back of your neck, the day prior to your procedure.
- You are to have nothing to eat or drink after midnight on the night before.
During Cervical Laminectomy
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.
After procedure
- Patients are typically admitted to the hospital for a 2 night stay.
- In the recovery area, you will be observed until you recover from the anesthesia, then transferred to the floor.
- You will be encouraged to get out of bed and move around as soon as you are able to.
- Pain pills on an empty stomach may result in nausea, so initially IV pain medications are self administered through a PCA, or patient-controlled analgesia.
- IV fluids will be continued until you can drink fluids well by mouth.
- Once you are able to drink normally, your diet will be advanced to your normal diet and you will be switched to pain pills.
- Physical therapy and occupational therapy will see you prior to your discharge from the hospital to make sure you are comfortable walking, escalating stairs and performing other activities of daily living.
- For most cases, a soft neck brace for a period of 2 weeks is all that is needed. Some patients, however, may require a hard cervical collar for 6 weeks.
What Happens After Discharge
- You should be ready for discharge from hospital 2-4 days after surgery. Your GP should check your wounds 4 days after discharge. Your staples require removal around 10 days after surgery, and this can be done by your GP or the Precision Neurosurgery Registered Nurse.
- You will need to take it easy for 6 weeks, but should walk for at least an hour every day.
- Bear in mind that the amount of time it takes to return to normal activities is different for every patient. Discomfort should decrease a little each day. Increases in energy and activity are signs that your post-operative recovery is progressing well. Maintaining a positive attitude, a healthy and well-balanced diet, and ensuring plenty of rest are excellent ways to speed up your recovery.
- Signs of infection such as swelling, redness or discharge from the incision, and fever should be brought to the surgeon’s attention immediately.
- A firm neck brace (‘Aspen collar’) is sometimes used after surgery (if you have had a fusion). This is generally worn for 6 weeks.
- You will be reviewed after 6-8 weeks by your neurosurgeon. Until then, you should not lift objects weighing more than 2-3kg, and should not engage in repetitive neck or arm movements.
- You should continue wearing your TED stockings for a couple of weeks after surgery.
Best Cervical Laminoplasty Surgeons in India
- Dr Hitesh Garg
- Dr. Sandeep Vaishya
- Dr. Arun Saroha
- Dr. Manoj Sharma
- Dr. V. K. Rajoria
- Dr. Amitabh Goel
- Dr. Rajagopalan Krishnan
- Dr. Bipin Walia
- Dr. Prakash Singh
- Dr. Manoj Miglani
Best Cervical Laminoplasty Hospitals in India
- Fortis Memorial Research Institute, Gurgaon
- BLK Super Speciality Hospital, New Delhi
- Indian Spinal Injuries Center, New Delhi
- Medanta – The Medicity, Gurgaon
- Indraprastha Apollo Hospital, New Delhi
- Artemis Hospital, Gurgaon
- Max Super Speciality Hospital, Saket, New Delhi
- Manipal Hospitals Dwarka, Delhi
- Asian Institute of Medical Sciences, Faridabad
- IBS Institute of Brain and Spine, New Delhi
List of Top 10 Cervical Laminoplasty Hospitals in India