What Is a Posterior Cervical Laminectomy?
Cervical spinal stenosis occurs when the spinal canal narrows due to degenerative changes or trauma. If the space within the spinal canal is reduced too much, neurological deficits can result in spinal compression. If most of the compression is in the back, the cervical stenosis can be treated with posterior cervical laminectomy. The goal of this procedure is to remove the lamina to give the spinal cord more room.
Causes for a Posterior Cervical Laminectomy
Your provider may recommend a spinal decompression if noninvasive treatments, like physical therapy or medication have failed to relieve pain caused by inflamed and compressed spinal nerves. It may also be recommended if you have signs of nerve damage, such as weakness or loss of feeling in your legs. You may be a candidate for a cervical laminectomy if you have:
- Significant pain, weakness or numbness in your leg or foot.
- Leg pain worse than back pain.
- Not improved with physical therapy or medication.
- Difficulty walking or standing that affects your quality of life.
- Diagnostic tests that show stenosis in the central canal or lateral recess.
Preparing for a Posterior Cervical Laminectomy
Before surgery, your provider will perform a physical exam and review medical history. You may also be scheduled for presurgical tests, like blood tests, ECG, or chest X-rays prior to the procedure. Some medications may need to be continued or stopped the day of surgery. Stop taking all non-steroidal anti-inflammatory medicines and blood thinners 1-2 weeks prior to surgery. Additionally, stop smoking, chewing tobacco, and drinking alcohol 1 week before surgery and 2 weeks after surgery as they can cause bleeding problems. No food or drink is permitted past midnight the night before surgery.
The morning of surgery, you should:
- Shower using anti-bacterial soap.
- Dress in freshly washed, loose-fitting clothing.
- Wear flat-heeled shoes with closed backs.
- Take medications (if instructed to do so) with small sips of water.
- Remove make-up, hairpins, contacts, body piercings, and nail polish.
- Leave all valuables and jewelry at home.
- Bring a list of medications with dosages and times taken.
- Bring a list of allergies to medications or food.
What to Expect in a Posterior Cervical Laminectomy
During the procedure, your surgeon will make an incision down the middle of your neck over the affected vertebrae. The lamina with the spinous process can then be removed as one piece, allowing the spinal cord to float backwards and give it more room.
If you have spinal instability or have laminectomies for multiple vertebrae, a fusion may be performed. This includes joining two vertebrae with a bone graft, held together with hardware such as plates, rods, hooks, or cages. There are several ways to create a fusion, and your provider will work with you to determine the best choice. The most common fusion, posterolateral fusion, is when the topmost layer of bone is removed with a drill to create a bed for the bone graft to grow. The surgeon may reinforce with hardware and the back muscles are replaced over the bone graft to hold it in place.
The results of the cervical laminectomy will vary from person to person. In general, most patients who undergo a cervical laminectomy can expect:
- Some spinal cord function
- Improvement in their hand function and walking capabilities.
- Less or no numbness in their hands.
Risk Factors of a Posterior Cervical Laminectomy
No surgery is without risks. Besides the general complications of bleeding, infection, blood clots and reaction to anesthesia, there are specific complications related to a cervical laminectomy, including:
- Deterioration in neurological functioning after surgery.
- Dural tear
- Increased pain
- Instability in the spinal column
If your temperature exceeds 101°F, or if the incision begins to separate or show signs of infection, contact your healthcare provider immediately.