Is Cervical Laminectomy a Major Surgery?

Cervical laminectomy involves surgically removing part or parts of the neck vertebrae to relieve nerve pressure and neck pain.

A cervical laminectomy is a surgical procedure performed on the cervical (neck) region of the spine. The spinal canal is protected by a series of bones called vertebrae. A part of each vertebra bone called the lamina abuts the lamina of adjacent vertebrae to form a bony, flexible tube (spinal canal).

In a cervical laminectomy, the laminae of a cervical vertebra are removed to widen the spinal canal and relieve the pressure on the spinal cord and nerves.

A cervical laminectomy can take1 to 3 hours to perform. It is a major spine surgery in a sensitive location on the backbone. It is usually performed only when symptoms are not relieved with non-invasive therapies such as:

• rest
• pain relievers
• physical therapy
• epidural or nerve sheath injections

It is generally considered a safe surgery, especially with the current technological advancements in the field of spinal surgery.

The spinal cord and spinal nerves run through the spinal canal formed by the laminae. When this space narrows, it compresses the spinal cord and irritates the nerve roots. This may result in conditions known as radiculopathy or myelopathy, which cause:

• pain
• weakness
• numbness
• tingling
• difficulty walking
• loss of bladder and bowel control

A cervical laminectomy relieves nerve compression caused by  spinal canal narrowing. It may be useful for patients with:

• degenerative disc disease
• arthritis
• spinal stenosis
• cervical spondylosis
• bulging or prolapsed disc
• bone spurs in the spine
• trauma to the spine

Cigarette smoking, frequent lifting, and diving are additional risk factors for cervical myelopathy.

An orthopedic surgeon or neurosurgeon performs the cervical laminectomy under general anesthesia. 

Preparation

• The patient undergoes blood and imaging tests prior to the surgery. 
• The patient must stop taking blood thinners, have nothing to eat or drink 8 hours prior to surgery, and check with the doctor before taking any regular medications. 

Procedure

• The patient lies flat on their abdomen during the procedure.
• The anesthetist administers the anesthesia and monitors the patient’s vital functions during the surgery.
• The surgeon makes an incision in the skin over the cervical vertebra that requires laminectomy.
• The surgeon removes a section of the vertebra called lamina. Where possible, they may just cut one side of the lamina to widen the space for spinal nervous tissue.
• The surgeon may also remove bone spur and damaged disc tissue.
• Sometimes the surgeon may also fuse two or more vertebrae to provide stability.
• The surgeon closes the incisions with sutures.
• The anesthesiologist brings the patient out of anesthesia and keeps them under observation until stable.
• The patient may be discharged in two or three days.

Post-surgery the patient is encouraged to walk within a day or two, and slowly increase activities as tolerated. 

The patient may require a neck brace to support the neck while healing for two to six weeks, depending on the number of vertebrae operated upon.

• Patients should avoid heavy lifting and strenuous activities during recovery.
• Physical therapy and rehabilitation might be required after healing is complete.
• Patients should be able to resume normal activities in six to eight weeks.

Cervical laminectomy is generally a safe procedure and most people heal from it with no significant problem. As with any major surgical procedure, cervical laminectomy has risks that include:

• anesthesia side effects like headache, nausea and confusion
• infection at the surgery site
• bleeding and blood clots
• injury to spinal cord, nerve roots or blood vessels
• leakage of cerebrospinal fluid
• failure of surgery to provide symptom relief
• aggravation of original symptoms
• kyphosis or excessive curve of the spine
• loss of bowel and bladder control, and impotence
• rarely, stroke and paralysis

Major complications from a cervical laminectomy are unusual, but do occur as listed above. Advancement in medical technology and surgical techniques have resulted in reducing risks to a great extent. About 90 percent of patients come out of the surgery with no complications.

Studies indicate that a majority of patients have symptom relief after a cervical laminectomy. The success of the procedure also depends on the degree of the patient’s disease. The surgery decompresses the spinal canal and relieves the pressure on the spinal cord and nerves.  It is not a cure for underlying disease like arthritis or degenerative disc disease.