Cervical Laminectomy & Lateral mass Fixation

Cervical laminectomy is a surgical procedure to open the spinal canal and relieve pressure on the spinal cord and spinal nerves to relieve shoulder and arm pain, numbness or weakness. The surgery is performed through an incision in the back of the neck. The bony arches that form the “roof” of the spinal canal are hinged open from both sides, increasing the dimensions of the spinal canal and creating more room for the spinal cord.

If You Have Decided to Have Surgery:

Lumbar laminectomy is a surgical procedure to remove bony pressure on the spinal canal and spinal nerves to relieve buttock, hip, and leg pain. Occasionally disc material needs to be removed. If there is instability of your spine you may require a posterior fusion of the spine. This procedure involves taking either bone graft (from your spine), or synthetic bone graft and packing it around the spine to create a solid bony fusion across the unstable segments. Usually titanium screws and rods are placed to increase the stability. Sometimes the lumbar disc is removed and replaced with a plastic cage filled with bone graft (TLIF).

Surgical Procedure

• Your anesthesiologist will bring you to the operating room and put you to sleep for the operation.
• There are usually two nurses in the room and a surgical assistant that assists Endospine360 doctors with the operation.
• You will be positioned lying on your stomach, face-down. An incision is made in the back of your neck.
• After carefully moving the muscle tissue to the sides, a retractor is placed to expose the back of the spine.
• One both sides of the spine, the lamina (bony arches) are cut where they meet the facet joints.
• On the other side, a bur is used to create a narrow groove in the bone, thinning the bone to the point where it becomes flexible. This allows the bone on that side to act as a hinge, and the arches can be opened, relieving the pressure on the spinal cord.
• The arches are held open with small bone grafts that are secured with tiny titanium plates and screws.
• A drainage tube may be placed under the muscles before closing the incision to keep any blood or drainage from collecting beneath the incision. This is usually removed on the 2nd or 3rd day after surgery depending on the amount of drainage.
• The incision is closed with resorbable stitches that are placed beneath the skin.
• The surgery will take approximately 2 hours.

After Surgery:

• You will be taken to the recovery room  and stay there for about 1hour. 
• Doctor will speak to your family while you are in the recovery room.
• The nurses will get you out of bed shortly after surgery and a physical therapist may work with you to ensure that you are strong enough to go home.
• You will be able to walk next day morning of surgery and usually discharged on post op day 2 of surgery.

After Going Home:

• You will be given pain medication and a muscle relaxant to help control post-operative pain and spasms. Make sure you do not drive or operate heavy machinery while on the medication.
• You will wear a soft neck brace for two weeks after surgery.
• You may begin driving at 2 weeks.
• You can expect to return to sedentary office or desk-work approximately 2 weeks after surgery.
• If you perform manual labor that requires heavy lifting you should wait 3 months before returning to this activity. You can return to moderate duty at 4-6 weeks.
• Sports activities such as running, golf, or tennis may be resumed at 3 months.

Potential Risks and Complications:

• Nerve root damage (0.5-1%)
• Tear of the nerve sac (“dural tear”) with leakage of spinal fluid (1-3%). Usually recognized during the procedure and repaired, causing no change in the outcome of surgery. Occasionally recognized after surgery requiring a period of laying flat to allow the tear to heal, or possible surgery to repair the tear.
• Infection (1-2%)
• Bleeding requiring a blood transfusion
• Medical complications such as heart attack, stroke, blood clots, and pneumonia. Risk is dependant on the patient’s medical condition and age.