Posterior cervical laminectomy and fusion may be performed to alleviate pressure from (decompress) the spinal cord, nerve roots and stabilize the neck (fusion).
The incision is made in the back of the neck.
The cervical levels are one region of the spine. There are seven vertebral bodies in the neck and are abbreviated or numbered C1 (top) through C7 (bottom). The disc levels are also abbreviated. For example, C5-C6 refers to the intervertebral disc between the fifth and sixth cervical vertebral bodies (bones).
The thin plate of bone at the back of the neck that makes up the roof of the spine and helps to protect the spinal cord is called the lamina. During a laminectomy, the bony plate is removed to allow him access to the spinal cord and other nerve structures.
Bone graft is added into the empty space between the upper and lower vertebral bodies. Instrumentation (rods and screws) is implanted to stabilize and immobilize the neck. New bone will grow into and around the instrumentation resulting in a spinal fusion, which is caused by the body’s natural healing process.
On average most patients with spinal stenosis, cervical degenerative disc problems, or herniation do not require spine surgery. However, Dr. Stieber may recommend posterior cervical laminectomy and fusion for the following reasons: if non-operative treatment fails to alleviate symptoms, progressive worsening of neurologic symptoms or pain, spinal instability, and/or neurological problems. For example, loss of function, numbness, and weakness are examples of neurologic dysfunction. Difficulty with fine motor movements, loss of manual dexterity, and disruption of balance may signal dangerous compression of the spinal cord within the spine could be signs of myelopathy.
At Dr. Stieber's office in New York, a laminectomy is performed under general anesthesia. To prepare the neck area for surgery, it is cleaned and shaved. The patient must be positioned face down (prone) on the operating table. With a specialized device, the patient’s skull is held securely in position and the neck is immobilized. A special nerve monitoring system also checks the spinal cord and nerve function throughout the procedure to prevent any injury. Fluoroscopy is an x-ray intended to guide instruments in real-time and allows visibility throughout the surgery to see the patient’s anatomy.
An incision is made in the middle of the back of the neck (a midline incision). Muscles and soft tissues are gently reflected from the spine. Specialized instruments are used to carefully remove the lamina and remove tissue and bone compressing the spinal cord and nerve structures. The lamina and other bone removed could be prepared and used for bone graft. The neck is then stabilized with rods, screws and bone graft to ensure fusion and healing happen properly and smoothly.
The patient is moved into the recovery area after the surgery. While in recovery, nurses and other members of our NYC medical team closely monitor the patient’s vital signs – blood pressure, pain, respiration and pulse. Some patients receive pain medication either through their IV (intravenous line) or by mouth after the surgery.