Laminectomy (Cervical) with Fusion
What is a Cervical Laminectomy?
A cervical laminectomy is a surgical procedure that can effectively relieve compression of the spinal nerves and resultant pain caused by spinal stenosis. Spinal stenosis is a condition that involves a narrowing of one or more areas of the spine, placing excessive pressure on the spinal nerves in the region. It often produces pain, cramping and numbness in the neck, shoulders or arms. This condition can develop as a result of injury or deterioration to the discs, joints or bones within the spinal canal.
In a cervical laminectomy procedure, a small section of bone that covers the back of the spinal cord, called the lamina, is removed. This type of surgery is performed through the back of the neck. The removal of this portion of the bone and any nearby bone spurs relieves the pressure on the spinal cord.
The cervical spine (neck region) is one of the most important and agile parts of your body. It begins at the base of the skull and consists of eight pairs of spinal nerves and seven bones separated by intervertebral discs that allow the spine to move freely. The neck has the greatest amount of movement of any area of the spine and is also responsible for protecting the spinal cord and supporting the skull. Because of its vital function in our everyday lives, injury or disease of the cervical spine is a very serious condition.
While many cases of spinal stenosis can be successfully treated through conservative methods such as physical therapy, nonsteroidal anti-inflammatory drugs, rest and a back brace, some patients do not respond to these measures. If the symptoms of spinal stenosis become progressively worse, a cervical laminectomy may become necessary. It can provide relief from the pain, numbness or weakness many patients experience in the neck, shoulders and one or both arms.
Cervical Laminectomy Procedure
A laminectomy of the cervical spine is performed through the upper back while the patient is under general anesthesia. Once the skin at the treatment site has been cleaned with an antiseptic, Dr. Lipani makes an incision and carefully retracts the muscles and ligaments to obtain access to the spine. An imaging device such as an X-ray is typically used during the surgery to view the structures of the vertebrae and pinpoint the problem area.
Depending on the extent of the damage, the lamina may be removed in portions or in its entirety on both sides of the spine. Dr. Lipani will then assess the region, removing any calcified cartilage as well as the spinous process, which are sharp protrusions at the back of each vertebrae, if necessary. By removing the lamina, bone spurs and other debris, the compression of the spinal cord and spinal nerves is alleviated and symptoms will improve.
If the bones within the cervical spine have been moving against each other, a spinal fusion procedure may be necessary to promote stability. This procedure can be performed at the same time the patient is undergoing the cervical laminectomy. The fusion involves inserting a bone graft taken from another part of the patient’s body or from a donor bank into the space between the affected vertebrae to encourage them to join together. Dr. Lipani will also attach titanium metal rods, plates and screws to the vertebrae to prevent movement of the bones while the fusion takes place. By restricting motion in the affected vertebrae, the chances of achieving a successful fusion increase substantially.
Recovery from Cervical Laminectomy
A cervical laminectomy should relieve much or all of the pain and numbness in the arms and neck that stenosis sufferers experience. After the procedure, you will most likely need to remain in the hospital for a short stay and possibly wear a brace on your neck. Soon afterward, most patients begin a physical therapy regimen to build up their muscle strength and flexibility. There will be restrictions from activities that require reaching, lifting and pushing or pulling for several weeks following the procedure. Generally, most people can return to work in approximately three months.
However, when a cervical laminectomy is accompanied by spinal fusion, recovery time may be longer. Sometimes it takes several months after this combination of procedures to be fully cleared for a normal resumption of activities.
Risks of Cervical Laminectomy
Cervical laminectomy is a spinal surgery procedure and as such, it carries some risk. The complications that may be associated with this procedure include infection, blood clot formation, nerve damage and an adverse reaction to anesthesia.