Cervical Laminectomy and Fusion
This procedure removes a section of bone from the rear of one or more vertebrae to relieve the painful and disabling pressure of stenosis. The spine is then stabilized with rods and screws.
A cervical laminectomy is a surgical procedure that can effectively relieve compression of the spinal nerves and so reduce the pain of spinal stenosis. Cervical spinal stenosis is a condition that involves a narrowing of the spinal column in the neck area. It often produces pain, cramping, weakness or numbness in the neck, shoulders or arms.
This condition can develop as a result of injury to, or deterioration of, the discs, joints or bones within the spinal canal. Because the vertebrae of the neck are more capable of movement than any other area of the spine and because they are not only responsible for protecting the spinal cord, but for supporting the skull, surgical repairs in this area are a delicate matter.
During a cervical laminectomy procedure, a small section of bone that covers the back of the spinal cord, called the lamina, is removed. If the bones within the cervical spine have been moving against each other, a spinal fusion surgery may be necessary to promote stability. This procedure can be performed at the same time the patient is undergoing the cervical laminectomy.
Candidates for Cervical Laminectomy and Fusion
Cervical laminectomy and fusion is usually recommended for patients with spinal stenosis that has not responded to conservative methods of treatment. Surgery may also be considered if the patient is experiencing progressively worsening symptoms of spinal stenosis that have begun to limit his or her normal daily activities.
The Cervical Laminectomy and Fusion Procedure
Cervical laminectomy and fusion is a surgical procedure that incorporates both a laminectomy and fusion in the area of the cervical spine. The primary goal of the surgery is to relieve pressure placed on the nerves by spinal stenosis. It may also be performed to treat other conditions, such as herniated discs and injuries to the spine.
During the cervical laminectomy portion of the surgery, a section of the lamina and any nearby bone spurs will be removed. It is performed through the upper back and neck while the patient is under general anesthesia. The surgeon 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 vertebral structures more precisely and pinpoint the problem area.
The spinal fusion portion of the surgery is performed to help stabilize portions of the spine after cervical laminectomy. This procedure may take several hours to complete. The fusion involves inserting a bone graft into the space between the affected vertebrae in order to join them. The bone graft is harvested from another part of the patient's body or is received from a donor bank The surgeon will also attach titanium metal rods, plates and screws to the vertebrae to prevent movement of the bones during the fusion process.
Recovery from Cervical Laminectomy and Fusion
Cervical laminectomy and fusion usually relieves much or all of the pain and numbness in the arms and neck that stenosis sufferers experience. After the procedure, the patient typically remains in the hospital for a short stay and may be fitted with a neck brace for temporary support.
Soon after surgery, most patients will begin a physical therapy program to build up muscle strength and increase flexibility. Patients are advised to avoid reaching, lifting, pushing or pulling for several weeks following the procedure. A complete recovery following cervical laminectomy and fusion often takes several months.
Risks of Cervical Laminectomy and Fusion
The results of a cervical laminectomy and fusion procedure are often highly effective and long-lasting, but complications may arise due to pre-existing medical problems such as diabetes or the severity of the patient's spinal issues. The possible risks associated with this surgery include:
- Infection from the surgical wound
- Nerve injury
- Spinal instability
- Long-term chronic pain
In some cases, the symptoms of spinal stenosis may also return after several years. This can lead to the necessity of a second cervical laminectomy and fusion procedure.