What is Posterior Cervical Laminectomy and Fusion?
Disc degeneration and joint degeneration cause most neck discomfort in the cervical spine. Many neck pain patients do well with conservative treatment. Occasionally, degenerative abnormalities in the cervical spine can cause excessive pressure on the spinal cord. When this condition manifests, the entire spinal cord is at risk. One method for relieving spinal cord pressure is posterior cervical laminectomy and fusion surgery, which widens the spinal canal from the back.
What is the Purpose of a Posterior Cervical Laminectomy and Fusion?
A posterior cervical laminectomy and fusion involves removing a portion of your spinal vertebrae and the lamina in your neck. The lamina is a region of bone in the back of the neck. Taking out the lamina gives the nerves more room, and bone spurs surrounding the nerves can also be removed. A laminectomy reduces spinal cord pressure and irritation and inflammation of spinal nerves.
Two or more vertebrae are then fused together to prevent movement, using a bone graft to stimulate bone fusion. The surgeon may combine autografts, or your own bone, with allografts supplied by donors. A surgeon may include medical implants and devices with your fusion, such as plates, pedicle screws, and rods. Using these implants can stabilize your spine and reduce micro-motion, preventing fusion failure.
When Do You Need Posterior Cervical Laminectomy and Fusion?
Surgeons perform the posterior cervical laminectomy and fusion as a treatment for spinal cord and nerve root compression caused by a variety of conditions, including:
Degenerative disc disease: A condition associated with aging in which the discs between the vertebrae lose their cushioning, fragment, and herniate. It causes the discs between your vertebrae to wear down over time, which can lead to pain and stiffness in your neck.
Herniated disc: A herniated disc occurs when there is a tear in the outer portion of a spinal disc. This tear causes part of the gel-like center of the IVD to push through its outer covering, putting pressure on nearby tissues.
Spinal stenosis: Narrowed spaces in your spinal canal reduce the amount of room available for your nerve roots that exit from the spine to travel down into your arms and hands. This can cause pain, numbness, or weakness in your arms and hands because of compression on these nerves.
Spondylosis: This is a degenerative spinal condition that causes the vertebrae in your spine to compress and become stiffer over time. Many people do not experience any back pain from this condition, but if they do, a posterior cervical laminectomy and fusion is often recommended.
The Procedure for Posterior Cervical Laminectomy and Fusion
The procedure starts with an incision on the back of the neck made by the surgeon. Next, the muscles of the neck are shifted to the side to reach the back of the spine.
An X-ray can help your surgeon locate the problematic vertebra. A laminectomy relieves pressure on the spinal cord and nerves in the back. However, the spine’s stability may be compromised by removing the entire lamina. Injuries to the facet joints during a laminectomy may cause instability in the spine.
To avoid this issue, spine surgeons leave the lamina in place and fold it back gently after cutting one side. The lamina opens from the other side like a hinge. By doing this, the spinal canal is made larger, allowing for a larger space for the spinal cord. It takes time for the cut lamina to heal so that the spine doesn’t tilt forward.
The surgeon will perform the fusion and instrumentation phases after decompressing the spinal cord and removing all compressive structures. The degenerated areas of your spine will be stabilized using screws, plates, and rods. Fusing this area will also require the use of bone graft material.
What to Expect After Surgery
Nursing and medical staff monitor your vital signs closely after surgery, treat your pain with medications, and give you IV antibiotics to minimize infection risk. It is possible to experience pain at the site of the incision or occasional muscle spasms in the neck. After surgery, you are placed in a neck collar and advised to limit your activities to aid in your recovery. Once your medical condition is stabilized, you can return home within a few days.
Your doctor may prescribe physical therapy four to six weeks after surgery. A rehabilitation program aims to improve mobility, strength, and ease of doing daily activities by calming pain and inflammation.
Find Out if Posterior Cervical Laminectomy and Fusion is Right for You
Posterior cervical laminectomy and fusion surgery is considered one of the most effective ways to address spinal issues caused by degenerative disc disease, herniated vertebral discs, stenosis, and other common conditions. If you believe you may be a candidate and conservative treatment has not brought relief, the best thing to do is to schedule an appointment with a orthopaedic surgeon who specializes in cervical spine surgery. To schedule an appointment, please complete this form.