Cervical Laminectomy

A cervical laminectomy is a surgical procedure that involves the widening of the spinal canal by removal of the lamina, which releases pressure over the spinal nerves and/or the spinal cord. The lamina is a small bony plate covering the spinal canal. Narrowing of the spinal canal may occur due to any of the following reasons:

• Wear and tear of the spine with age
• Degenerative changes leading to spinal stenosis
• Excessive and repetitive stress or strain on the spine causing disc collapse
• Herniated disc and bone spur formation can cause the compression of spinal canal

Procedure

Cervical laminectomy involves the following steps:

• The procedure is conducted under general anesthesia.
• The patient is placed face down, on the operating table.
• X-rays images are used to identify the location of the incision.
• An incision is made through the skin, in the middle, on the back of the neck.
• The muscles are retracted with the help of a retractor.
• A surgical microscope is employed to magnifying the view of the area being operated.
• During laminectomy, only partial cutting of the lamina is done on one side, since complete removal of the laminae involves the loss of the facet joints and may cause a forward inclination of the spine.
• This partially cut lamina forms a hinge like structure and relieves the pressure over the spinal cord.
• Soft tissues present around the spinal nerves are carefully removed with small cutting instruments.
• Any bone spurs or intervertebral disc fragments present near the nerves are also removed.
• All of these surgical interventions help in relieving the pressure over the spinal nerves.
• Finally, the muscles and soft tissues are repositioned and the wound is sutured.

Post-operative care

Patients are usually discharged on the same day of the surgery and can resume driving within 1-2 weeks of the surgery. General post-operative instructions for a patient after a cervical laminectomy include:

• Use of soft neck brace
• Keep the incision clean and dry
• Move the neck with care and comfort
• Patient can get back to work after 3-4 weeks
• Avoid heavy work or any sport for at least 2-3 months
• Physical therapy is recommended for the strengthening of the weak muscles

Risk and complications

There are always some complications associated with any major surgery. Some of the complications associated with lumbar laminectomy include infection, spinal nerve injury, persistent pain, instability of the spinal fragments, and thrombophlebitis.