Surgical Procedures
CERVICAL LAMINECTOMY


1. WHAT IS A CERVICAL LAMINECTOMY?

Cervical laminectomy is a procedure that is performed  on the back of the neck to remove pressure from either the nerve roots or the spinal cord in the neck.

2. WHAT CONDITIONS ARE TREATED BY THIS OPERATION?

The conditions that give rise to pressure on the nerve roots or the spinal cord include a herniated disc, bone spurs, calcium deposits, tumors, possibly bony fragments from a fracture, or infection. These cause arm numbness and pain.

3. WHAT ARE THE DETAILS OF THE OPERATION ?

Very often decompressing nerves in the neck is done together with a fusion. However, there are occasions when the cervical spine is considered stable enough that a fusion is not necessary, and only decompression of the nerve (laminectomy) is required. In order to perform a cervical laminectomy, a vertical incision is made in the back of the neck centered over the segments of the cervical spine that need to be decompressed. The incision goes through the skin, subcutaneous tissue, and muscles, until the spine is exposed. The laminectomy involves removing the lamina (the bony covering to spinal canal) where the nerve roots and spinal cord are situated. If there is only a small area of pressure on the nerves, a limited laminectomy, called a laminotomy, is carried out. During the laminotomy, only a small portion of bony lamina is removed, together with the adjacent ligament. However, in situations where there is a greater amount of pressure on a nerve, then a complete laminectomy will have to be carried out. The surgery is frequently done with a microscope to aid in the dissection. The position of the patient during surgery is usually in the prone position. The surgery is done under a general anesthetic, with the patient completely asleep. Generally speaking, it takes between 1 1/2 to 3 hours to perform a laminectomy.

4. WHAT ARE THE POTENTIAL COMPLICATIONS?

The potential complications of laminectomy include bleeding and the risk of transfusion, nerve damage to the nerve roots and to the spinal cord (including potential paralysis and quadriplegia, which may be permanent), infection, failure to relieve pain, the potential for developing eventual long term instability (which may require further treatment and surgery, such as a fusion). Medical complications are also possible, and these can be catastrophic, including death. If the patient has any concomitant medical conditions, these should be reported and worked up thoroughly by the patient's own internist or family doctor before proceeding on to surgery. Therefore, if the patient has any medical conditions, it is important to let the surgeon know, so that the proper steps can be taken to prevent medical complications.

5. WHAT WILL MY HOSPITAL STAY BE LIKE?

You will check into the hospital approximately two hours before surgery (the nurse will give you a time and directions). You will wait in the holding area of the operating room for about 30 minutes before surgery. This is where you will meet your anesthesiologist. After surgery you will wake up in the Recovery Area where you will remain for 1 to 2 hours. There will be a catheter in your bladder. The catheter is usually removed on the 1st or 2nd day. However, if you are unable to urinate you may need to be re- catheterized. Due to the anesthesia and medications, many patients have a poor recollection of this time period. We will try very hard to keep you as comfortable as possible with IV narcotics. You will be able to control the amount of pain medication you receive by using a small push button (PCA). You can push the button as often as you need as the machine will control the dose. We have been very happy with the amount of pain control we can obtain with this machine.

Depending on the number of levels decompressed, you may be in the hospital 1 or 2 days. You will be given a soft cervical collar to wear for comfort. You may shower 10 days after the surgery when the wound is healed.