Posterior Cervical Laminectomy/Laminoplasty

Posterior cervical laminectomy and fusion (PCLF) is a surgical technique directed to decompress the spinal cord or nerve roots (cervical region) and stabilize the neck.

Spine degenerative conditions such as bulging or herniated disc, stenosis, spondylosis, and many others of the cervical region may induce neck pain due to compression of the associated spinal nerves. This pain or numbness may extend to the upper extremities. The purpose of PCLF surgery is to diminish the pain by decompression of the spinal cord or nerves.

Anatomical terms:

  • Posterior: means back
    The surgical approach is from the back of neck.
  • Cervical: means neck
    Cervical region is the upper part of the spine. There are seven cervical vertebrae: C1- C7
  • Laminectomy: means to remove the lamina
    Lamina is a thin plate of bone at the back of each spinal vertebra which forms the roof and shields the spine. This layer of bone is removed during surgery.
  • Fusion: means to join
    Fix the bones together during the healing process.

Indications:

PCLF Surgery is offered only after conservative treatment has failed to adequately relieve the symptoms of pain, numbness, and weakness over a significant period of time.

Pre-operative preparation:

Prior to the surgery, you will be explained about the procedure and its complications by your surgeon. A medical examination will be performed by your doctor. A few investigations such blood-sugar tests, X-rays may be recommended to determine your health status.

Surgical technique:

PCLF is generally performed under general anaesthesia. The patient will lie face down on the surgical table. A special monitoring system checks the spinal cord and nerve function throughout the procedure. Fluoroscopy is used to enhance the visualization of the operative site.

An incision is made in the back of the neck. The spine is cleared of muscles and soft tissue so that lamina is visible. The exposed lamina along with the tissue and bone are removed to gain access to the spinal cord and nerves. This completes the procedure of decompression. Fusion involves use of bone grafts to fill the space between the affected vertebrae to promote bone growth. Implant materials such as screws and rods are used to fix the vertebrae together during the recovery period.

The traditional PCLF surgery is replaced with a minimally invasive method which employs tiny incisions that causes least damage to the muscles and soft tissues.

After surgery:

You will be transferred to the recovery room after your surgery is completed. Your vitals will be carefully monitored by the medical staff. You might feel discomfort and numbness due to the post-anaesthesia effects.

Post-operative course:

Keep the incision clean and dry to avoid infection. Activities like lifting heavy-weight objects, driving, and smoking are restricted. Start with the medications prescribed by your doctor. A cervical collar or brace is suggested to wear to help support and stabilize the neck. Start physical therapy as recommended to strengthen the neck muscles. Please follow the post-care instructions for a faster recovery.

Risks and complications:

PCLF is a major surgery. Both treatment and outcome are specific to an individual patient and vary for each patient. Complications of PCLF may include infection, excessive blood loss, inadequate fusion, and nerve injury.

If you observe any of the following signs of infection, you should call your doctor immediately:

  • Fever higher than 101°F
  • More redness or swelling around the incision(s)
  • Extra fluid drainage from the incision(s)
  • Incision has open areas along its length

You should also call your doctor if you experience chills, nausea/vomiting, or suffer any type of trauma such as a fall or a car accident. Difficulty in urinating or controlling your bowel movements is a medical emergency and in such a situation you should contact your doctor immediately.

Call your doctor if you have any worries or questions.

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