Cervical Laminectomy with or without Fusion
Occasionally, multiple discs can bulge and/or herniate, and the ligaments in the back portion of the spine can buckle into the spinal cord or nerve roots resulting in spinal stenosis. Cervical spinal stenosis can place pressure on the spinal cord. The result of pinching of the spinal cord can be a very slow loss of coordination, loss of balance during walking, tingling in the arms and/or legs, and even loss of bowel and bladder control.
If multiple discs are involved, fusion from the front can be difficult. Often this condition can be treated with a posterior laminectomy. The objective of this procedure is to remove the bone and ligaments to give the spinal cord more room. The spinal cord is especially sensitive to injury, and once the progression of pinching leads to significant loss of function, this function may not be reversible even with removal of the offending agent(s).
The skin incision is in the midline of the back of the neck and is about three to four inches long, and the spinal muscles are then separated off of the bone. Special surgical instruments are carefully utilized to remove the bone and ligament, with great care being taken not to press on the spinal cord. Often, special neurological monitoring is used during the procedure to let the surgeon know immediately of any change in the spinal cord function.
Cervical laminectomies are sometimes done with a cervical fusion. If a posterior laminectomy is done without a cervical fusion, there is a post-operative risk of developing instability that may lead to pain and deformity. Small screws may be placed into the bones of the neck, and connected together with a titanium bar. Pieces of bone are then placed along the sides of the neck bones so that they will grow together (fuse).