A cervical laminectomy is performed to relieve the compression of the spinal cord and nerves around your neck. This is achieved by making the spinal canal wider, creating more space for your nerves. A part of the protruding bone or the lamina is either removed or trimmed during this procedure. The surgeon may either fuse your vertebrae or totally remove a section of your spinal disc.
Do I need a cervical laminectomy?
Several conditions may lead to a cervical laminectomy. In most cases, it is done because of a disorder in your spine that causes pain, which hinders your daily routine. The following are reasons that may lead to a cervical laminectomy:
- To release the pressure exerted by various conditions in your spinal cord and in the area of your neck.
- To ease pressure exerted on the nerves around your neck.
- To correct a situation where the cervical spine is not stable. For this condition, you have to undergo a spinal fusion.
Your surgeon will advise you that you need surgery only after your having tried all the available treatment alternatives. If you have an infection in your spine or nerves, your doctor may also decide that you should undergo surgery.
What exactly is wrong with my neck?
The spinal canal and vertebral foramen consist of bony tunnels in your spine. The spinal cord and nerves run through these bony tunnels. There is compression in these tunnels if their sizes are reduced. There are several symptoms if this occurs and they include:
- tingling sensations
The above-mentioned symptoms may spread to other parts of the body because your spinal nerves spread to form peripheral nerves. The other body parts affected by this may include the:
There are several disorders that may cause pressure on the nerve roots. These conditions include:
- spinal stenosis
- degenerative disc disease
- a bulging or prolapsed intervertebral disc
- bone spurs (osteophytes)
- spondylosis (osteoarthritis of the spine)
In most cases, a number of these conditions happen at the same time. In between each of the bones of the spine, there are intervertebral discs. They absorb shock when the bones in your neck move. The outer ring of your vertebrae consists of fibers, while the central inner part consists of a jelly-like substance. The hardest part of your vertebrae is known as the annulus. It is the part that joins each of your vertebral bones together. The annulus mainly performs the function of absorbing shock. When it is torn, you are said to have an annular tear. If you have an annular tear, you may experience pain in your neck without necessarily feeling any pain in your arms.
Another situation that causes compression is when your cervical disc collapses. A herniated cervical disc can cause compression of your spinal cord and nerves. When you have a degenerative disc condition, your discs shrink and result in herniated discs. You may also have a condition known as osteoarthritis. This type of degeneration may cause you:
These originate from the pressure exerted on the spinal nerves or spinal cord.
If you have a prolapsed disc, the abnormal bony protrusions resulting from the degeneration process are known as osteophytes. The protrusions may cause a condition known as spinal stenosis. This may result in pressure on the spinal cord and nerves. When you have these protrusions, they can be corrected when you undergo a decompression procedure.
Your neck has so many functions. For this reason, it is exposed to several risks of injury. When you have an accident, for example, your cervical spine may be dislocated or injured. You may also injure your spinal cord in very severe cases and require surgery to stabilize your spine.
When your neck suffers instability, you may suffer pain or compression of the nerves. It may be caused by:
- rheumatoid arthritis
The instability usually calls for a surgical stabilization.
What are the alternatives to a cervical laminectomy?
There are various alternatives to a cervical laminectomy, depending entirely on your health condition. The alternatives include:
1. Pain relievers
Your doctor may prescribe medications that are useful in relieving your pain. They include:
- standard opioids
- non-opioid analgesic agents
- membrane-stabilizing agents
- pregabalin (yet to be released)
In some situations, you may be given ketamine infusions.
2. Nerve sheath injections
The doctor may have a local anesthetic injected into your neck to release the pressure on the compressed nerves. This procedure may help you avoid or delay surgery. The relief, however, is usually merely temporary, and the procedure is mostly used for diagnosis as the benefits wear off with time.
3. Physical therapies
Physical therapies can include:
4. Activity modification
You may at times heal simply by changing your routine and recreational activities. Avoiding lifting heavy things, and doing light rather than heavy exercises, and doing repetitive movements of the neck and arms may also help.
5. Other surgical approaches
Other types of surgery include:
- anterior cervical decompression and fusion
- artificial disc replacement
You should talk with your doctor to discuss and explore the alternatives and their potential risks.
What are the goals or potential benefits of surgery?
Cervical laminectomy has a number of goals and hoped-for benefits. After a successful cervical laminectomy, pain and numbness are relieved. The procedure may also ease the tingling and weakness around your neck, spine, and arms. You will also be able to take control of the motion of your spine and restore the functionality of your nerves.
The objectives and benefits of a cervical laminectomy come down to:
- the relief of pressure exerted on the nerves and spine
- the alleviation of pain
- the reduction of medicine intake
- prevention of spinal deterioration
- stabilization of the spine
- protection of spinal nerves and cord damage
Typically, the following symptoms reliably lessen after your surgery:
Occasionally, the pain might not go away, but it only happens in very rare cases. Your weakness is supposed to improve, too. You may not regain your normal strength, but you will notice that you are stronger than you were prior to the surgery. After the surgery, you may still experience numbness or pins and needles. Feeling pins and needles may go away in a month or so, but the numbness may take twelve months to disappear. With time, your ability to walk will also improve, but it also depends on whether the compression has damaged your spinal cord or not.
Beneficial and successful cervical laminectomy rely on a number of factors. During discussions, your doctor will help you determine whether your surgery is likely to be successful or not.
What are the possible outcomes if treatment is not done?
If you do not find and undergo the proper treatment for your condition, you may experience the following outcomes:
- persistent pain
- persistent weakness and numbness or even paralysis
- inability to walk and balance appropriately
Are there complications during surgery?
Generally, cervical laminectomy has a success rate of over 90 percent. The chance of developing complications is only at 3 percent.
What do I need to do before surgery?
If you are a smoker, you have to stop two weeks before your surgery and continue to abstain for a year after the surgery. You should also go on a weight loss program in case you are overweight.
What happens immediately after surgery?
You will typically experience some pain in the incision area. You will be encouraged to move around a few hours after the surgery to help your blood circulate. You should be able to drink or eat something four hours after the operation.