Cervical Laminectomy
What is it?
Cervical Laminectomy is a surgical procedure that aims to decompress the spinal cord and nerve roots in the cervical spine. It is usually performed on patients with cervical spinal stenosis, which is often caused by degenerative changes such as hypertrophy of the ligamentum flavum, osteophyte formation, or spondylotic changes that lead to spinal canal narrowing. This procedure is also used to address certain spinal tumors, infections, or congenital anomalies that cause spinal cord compression.
Cervical Laminectomy is effective in relieving symptoms of spinal cord compression, such as myelopathy and radiculopathy. Patients often experience significant improvement in function and reduction in pain and neurological symptoms.
Postoperative care may involve physical therapy to strengthen neck muscles and improve range of motion. In cases where fusion is performed, using a cervical collar and restrictions on certain activities might be necessary to facilitate bone healing.
Procedure
The approach to Cervical Laminectomy involves a midline posterior incision. After dissecting through the nuchal ligament and paraspinal muscles, the surgeon exposes the laminae, which are the posterior parts of the vertebrae forming the roof of the spinal canal. One or more laminae are removed (laminectomy) to create more space within the spinal canal.
In cases of significant spinal instability or deformity, a laminectomy might be combined with spinal fusion. This involves the use of bone grafts, and possibly hardware like rods and screws, to stabilize the spine post-decompression.
The precision of bone removal is critical to avoid unintended damage to the spinal cord or nerve roots. Intraoperative neuromonitoring is often employed to continuously assess the spinal cord’s and nerves’ functional integrity during the procedure. This monitoring is particularly important in cases with severe stenosis or when multiple levels are being decompressed.