What are the indications for a cervical laminectomy and fusion?
A posterior cervical laminectomy and fusion is a procedure used to decompress and stabilize the cervical spine. The goal is to relieve pain, weakness, and numbness in the arms and legs from pressure on the spinal cord and nerves due to narrowing of the spinal canal, a condition known as cervical spinal stenosis. A posterior cervical laminectomy and fusion may be recommended if the MRI study shows that the major compression of the spinal cord or nerves is coming from joint arthritis (as opposed to disc herniation) which are accessed from an approach from the back of the neck.
How is a posterior cervical laminectomy and fusion performed?
The surgery is performed under general anesthesia. The skin incision is in the midline of the back of the neck and is about 3 to 4 inches long. he muscles are separated from the lamina which are the bones of the back of the spine. The lamina of the spine are then removed to make room for the spinal cord and nerves. The bone removed is then packed into the joints to fuse the joints and prevent future deterioration of the neck. A screw and rod system known as lateral mass screw instrumentation is anchored into the bone to provide additional stability of the spine. The surgery can take anywhere from 3-6 hours depending on the complexity.
What is the recovery from a cervical laminectomy and fusion surgery?
The hospital stay usually varies from 2-5 days depending on the extent of surgery and overall condition of the patient. Most patients go home with home care help setup such as a visiting nurse and a physical therapist. Some patients may benefit from a short stay (several weeks) at a rehab facility. There is usually neck discomfort. The neck pain may radiate into the shoulder blades and arm regions and headaches are not uncommon. The surgical incisional pain typically significantly improves within 6-8 weeks. Activity recommended for the first 2 weeks after surgery is short walks and mainly rest. Physical therapy guidance is recommended from 2-3 weeks after surgery for 6-8 weeks. Return to work can vary depending on the extent of surgery, rate of recovery, and physical demands of the job. For nonphysical job, reasonable timeline to return to work is 3-4 weeks to 3 months whereas more labor intensive work may require to be out of work for up to 3-6 months.