Cervical Laminectomy without Fusion

Cervical laminectomy is a spinal surgery to the neck area in which a section or all of the lamina (the bony arch of the posterior segment of the cervical vertebra) that covers the spinal canal is removed. This is performed to create more room within the spinal canal to relieve pressure on the spinal cord and nerves. The surgery is usually recommended when conservative treatment measures such as medications, rest, nerve sheath injections, and physical therapy have failed to resolve neck pain and other symptoms associated with cervical spine and nerve compression.

Indications

Cervical laminectomy is commonly indicated for a condition called cervical spinal stenosis. Spinal stenosis is a narrowing of the spinal canal caused by degeneration of the facet joints and intervertebral discs. In addition, these arthritic facet joints become bulkier and consume the space available for the nerve roots. Bony outgrowths, also known as bone spurs or bone osteophytes, can also narrow the spinal canal. Spinal stenosis puts pressure on the spinal nerves and cord, causing symptoms such as neck pain, tingling, numbness or weakness that can extend to the shoulders, arms, and hands. Cervical laminectomy helps to reduce pressure on the spinal cord and nerves by removing the part of the lamina that is causing the pressure.

Preparation

Preoperative preparation for a cervical laminectomy may involve the following:

• Routine blood work and imaging of the cervical spine
• Informing your doctor of any medications or supplements you are taking
• Informing your doctor of any allergies to medications, anesthesia, or latex
• Disclosing any recent illnesses or other medical conditions you have
• Temporarily stopping some medications, such as blood thinners, for a defined period prior to surgery
• Refraining from solids or liquids at least 8 hours prior to surgery
• Arranging for someone to drive you home after the procedure

Surgical procedure

In general, cervical laminectomy surgery involves the following steps:

• You will be placed on the procedure table in a face-down (prone) position under general anesthesia.
• Your surgeon makes an incision on the back of your neck, along the midline, and gently separates the muscle tissue to access the neck bones (cervical vertebrae).
• Your surgeon then removes all or a section of the lamina of the cervical vertebra to relieve pressure on the spinal cord/nerves in the region.
• Other compression sources such as bone spurs, thickened ligament tissue, or all or part of a disk, will also be removed.
• After the procedure, your surgeon returns the soft tissue and muscle to their normal position and closes the incision with stitches or surgical staples.

Postoperative care

After surgery, you will be transferred to the observation room where your nurse will monitor your vital signs. You may feel pain and discomfort in the operated area. Medications are provided as needed to address this. You are encouraged to walk as soon as possible to maintain normal blood circulation and thereby prevent the risk of blood clot formation in the legs. A soft collar may be prescribed for neck support and comfort, and to limit movement of the neck. Physical therapy focusing on the neck will be started 4 to 6 weeks after surgery and involves stretching and range-of-motion exercises. Instructions on surgical site care and bathing will be provided to keep the wound clean and dry. You should avoid strenuous exercise or activity until you receive your doctor’s consent. On average, patients are discharged from the hospital 2 to 3 days after surgery. A follow-up appointment will be scheduled to monitor your progress.

Risks and Complications

Cervical laminectomy is a relatively safe procedure; however, as with any surgery, some risks and complications may occur, such as the following:

• Infection
• Bleeding
• Blood clots in the legs or lungs
• Adverse reactions to anesthesia
• Spinal cord or nerve root injury
• Injury to nerves or blood vessels
• Spinal instability
• Dural tear
• Neuropathic pain

Summary

A cervical laminectomy is a procedure in which your surgeon removes a part or all of the lamina portion of the vertebra. This serves to relieve pressure from the spinal cord and nerve roots, caused by a narrowing of the spinal canal (stenosis), tumors, herniated disks, or injury. Cervical laminectomy is only considered when nonsurgical treatment has failed to provide satisfactory results.