Posterior cervical laminectomy and fusion may be performed to alleviate pressure from (decompress) the spinal cord, nerve roots and stabilize the neck (fusion).

There are many disorders that may compress the spinal cord and nerve roots. These can include: spinal stenosis, bulging or herniated disc(s), disc degeneration, and osteoarthritis (spondylosis). Certain types of neck, shoulder, upper back, and arm pain and discomfort can be caused by compression or pinching of these neurologic structures. Other neurologic symptoms may include tingling, weakness and numbness in the hands or arms. When the spinal cord is compressed, this can cause injury and dysfunction of the spinal cord termed myelopathy. Patients with cervical myelopathy can experience loss of balance when walking as well as numbness, weakness, and clumsiness of the hands. Cervical myelopathy is a serious condition that requires appropriate treatment.

The purpose of posterior cervical laminectomy and fusion is to decompress the spinal cord and nerve root(s), stabilize the neck, diminish symptoms, and help our New York patients to resume their regular daily activities. Don’t hesitate to contact us to learn more about the laminectomy by NYC's spine surgeon, Dr. Stieber.

Posterior = back

The incision is made in the back of the neck.

Cervical = 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).

Laminectomy = to remove the lamina

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.

Fusion = to join or combine

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.

What Are the Types of Bone Graft?

Numerous post-operative x-rays are taken to be sure that the bone graft, screws and rods are properly positioned. The wound is then bandaged and closed.

Autograft is the patient’s own bone. Autograft may be recycled bone taken from the patient’s neck during a laminectomy or in a separate procedure where the bone is taken from the patient’s hip.
Allograft is donor bone from a bone bank.
Bone graft substitute. There are different types, some of which are synthetic (man-made) and available in different shapes.

About Posterior Cervical Laminectomy and Fusion

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.

What Happens After Surgery?

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.

A post-operative collar or cervical brace is often recommended to wear after surgery to help support and immobilize the neck while healing.
Dr. Stieber discusses hospitalization with patients before their surgery date. A typical hospital stay is 2 to 3 days.

Learn More About Dr. Stieber

What Should I Do for Aftercare at Home?

Dr. Stieber provides his patients with information about what to expect and self-care after hospital discharge. This information includes instructions to manage your diet and constipation, control pain, medications, brace/collar/halo care, how to properly bathe and clean the incision, and any activity restrictions. Dr. Stieber prides himself in delivering among the top laminectomy in New York and as always, he and his staff are happy to answer any questions and ensure that all patient considerations are thoroughly addressed.

Laminectomy in NYC