Overview

This procedure is often performed to treat conditions such as cervical stenosis, myelopathy, or significant spinal cord compression caused by degenerative disc disease, herniated discs, or bone spurs. It decompresses the spinal cord and nerves while stabilizing the spine to prevent further degeneration.

Why Choose Cervical Laminectomy & Fusion?

This surgery is typically recommended when conservative treatments like physical therapy, medications, or injections have failed, or when there is progressive spinal cord dysfunction. It relieves nerve compression and stabilizes the spine, helping to prevent further degeneration or deformity.

What to Expect During Surgery

The procedure involves several key steps:

• Preparation: On the day of surgery, you are admitted to the hospital. You will fast as directed, and general anaesthesia is administered. Spinal cord monitoring leads and a urinary catheter are placed for safety and fluid monitoring.
• Surgical Approach: You are positioned face down on the operating table with your head secured in a specialized frame. A midline incision is made at the back of the neck over the affected vertebrae, and intraoperative X-rays help localize the correct level.
• Laminectomy Procedure: The laminae of the affected vertebrae are removed using specialized tools, relieving the pressure on the spinal cord and nerves. Bone spurs or disc material may also be removed if contributing to the compression.
• Fusion Procedure: Bone graft material (from your body, a donor, or synthetic) is placed between the vertebrae to promote fusion. Metal implants such as screws and rods are used to stabilize the fused segment until a solid bone bridge forms.
• Closure: The surgical site is closed with sutures and a sterile dressing is applied. A drain may be placed to prevent fluid accumulation.

A schematic representation of the cervical laminectomy & fusion procedure.

Long-Term Outlook

Many patients experience significant relief from symptoms such as neck and arm pain following this surgery. However, recovery of chronic spinal cord damage symptoms can be unpredictable. There is some loss of neck motion, depending on the number of levels fused and the condition of adjacent segments.

Postoperative Care and Recovery

• Hospital Stay: Typically, patients remain in the hospital for about 3 days, depending on overall health and recovery progress.
• Pain Management: Pain is managed with medications, and early mobilization is encouraged to prevent complications.
• Rehabilitation: A rehabilitation program, including physical therapy, will be initiated soon after surgery to restore mobility and strength. A neck collar may be prescribed for the first 6 weeks, and activity restrictions are in place for about 3 months.
• Follow-Up: Regular follow-up appointments (at 2 weeks, 6 weeks, 3 months, 6 months, and 12 months) are scheduled, with X-rays performed to assess fusion progress.

Risks and Complications

• Infection: A risk of infection exists at the surgical site.
• Bleeding: Excessive bleeding during or after surgery may occur.
• Nerve Injury: There is a risk of injury to the spinal cord or nerves, potentially causing neurological deficits.
• Non-Union: In some cases, the bones may not fuse properly, possibly requiring additional surgery.
• Adjacent Segment Disease: Increased stress on segments above or below the fused area may lead to future degeneration.