For those who suffer from cervical spinal stenosis, a narrowing of the spinal canal commonly caused by age-related changes to the spine, spondylosis or an intervertebral disc prolapse, a cervical laminectomy may provide relief. Those with arthritis or severe degeneration, or those who have experienced trauma may benefit from having a fusion as part of the procedure, as well.
A cervical laminectomy reduces the pressure on the spinal cord, relieving symptoms such as shooting pain in the arms and legs, heavy feeling in the legs, a slow gait and deterioration of fine motor skills caused by this pressure. During the surgery, part of the vertebra, the lamina and the bony protrusion attached to it are removed.
Before surgery, take steps to increase your chances of a positive outcome. These steps are based on the individual but often include changing medications, stopping smoking and losing weight. Some doctors may recommend a protocol of zinc tablets before and after surgery to promote wound healing. A surgeon won’t recommend surgery unless other interventions have failed and proper tests have been done. These tests include x-rays, CTs and MRIs to provide doctors with a better look at the cervical spine. If imaging is inconclusive, nerve conduction studies and/or a nerve block may be used to provide better answers.
Cervical laminectomy surgeries are performed under general anesthesia and a breathing tube will be put in to protect the airway during surgery. To prevent infection and nausea, medicine will be given intravenously, as well. Local anesthetic is also used to treat the area the incision will be made.
The surgical team typically includes a neurosurgeon, a surgical assistant and an anesthetist. The surgery begins with a three to four inch incision along the midline of the neck. Then, paraspinal muscles are stripped away to allow access to the spine. The surgeon will use a high-speed, rotating wheel like instrument to cut a small trough on both sides of the affected lamina and remove the affected areas. In some cases, more than one lamina and bony protrusion may need to be removed. The surgeon can also perform a cervical spinal fusion, which includes fusing two vertebrae together using a bone graft and often a metal plate and screws, in the same procedure to provide additional stabilization of the spine. Then, the incision is closed with stitches and some patients may have a wound drain inserted for one to two days.
After surgery it is normal to feel some pain especially at the incision site. Most patients are on their feet within a few hours or the procedure. After a short hospital stay (2-4 days) the majority of patients are sent home to heal. It takes about six weeks before most can return to normal activities. During this period, wounds will need to be checked by a doctor and staples and stitches removed. Sometimes a neck brace is required for the six weeks.
The purpose of cervical laminectomy is to reduce or eliminate symptoms caused by cervical spine stenosis when other interventions have failed, which is done by relieving pressure or pinched nerves in the cervical spine. With fusion, the spine can also be stabilized, which is often necessary if more than one vertebrae has been affected. Most patients notice relief from pain, aching, stiffness, numbness, tingling sensations and weakness in the neck and other parts of the body.
Those who undergo a cervical laminectomy typically report less pain as well as reduction or elimination from other symptoms stemming from a reduced tunnel for the spinal cord and nerve roots to pass through. Patients also typically have improved nerve function and the surgery can prevent abnormal motion in the spine as well as further deterioration by relieving pressure on the spine and its nerves. Many patients are able to reduce the amount of medication they take after surgery, as well. Stabilization of the spine is possible, especially when fusion is done as part of the procedure. Arm pain and muscle weakness usually recover best while neck pain and headaches may or may not improve, with a small number of cases reporting worsening of these symptoms post surgery. If damage has already been done to the spinal cord and spinal nerves, symptoms of numbness and balance may not improve either. If you don’t experience a relief of numbness immediately, don’t fret. That symptom can take up to 12 months to really improve. Without treatment, however, persistent pain, paralysis, weakness, numbness, functional impairment problems with walking and balance are common.
Major complications are not common during cervical laminectomy. The rate of minor complications is also low; with three or four out of every 100 patients experiencing a minor complication. Risks of the surgery include return of or no relief from symptoms, worsening of pain, weakness and numbness, infection, a blood clot, fluid leak, blood loss that could lead to an infection, implant failure or movement, quadriplegia, incontinence, impotence, chronic pain, instability or collapse of the neck that requires surgery and stroke. General anesthesia carries its own risks including death, drug allergy, pulmonary embolism and infection, but most of these complications are rare.
The main symptom cervical laminectomy improves is pain, especially in the arm. Other symptoms including pain in the neck, headaches, numbness and weakness may or may not improve with surgery.
Before surgery is recommended, most patients undergo other treatments including: pain medication, nerve sheath injections in the compressed nerves to relieve pain, modification of activities, physiotherapy, osteopathy, hydrotherapy and massage. Other surgical procedures are also an option. Ask your doctor about artificial disc replacement, foraminotomy and anterior cervical decompression and fusion (ACDF).
Total costs of a cervical laminectomy can run between $24,415 to $26,793, including both the laminectomy and the fusion. It is not uncommon for the total cost of diagnosing, treating and recovering from spinal surgery to cost $100,000 before insurance. If you have insurance, it will often cover some or all of the procedure so check with your provider for an estimate. Where the surgery is done and by who will also impact final cost. Don’t forget to factor in other expenses, including a neck brace, post-surgery care and physical therapy.
Burke, Stephanie. “A Step-by-Step Guide to Cervical Laminectomy Surgery.” Spine-health. Accessed May 03, 2018. https://www.spine-health.com/blog/how-cervical-laminectomy-surgery-helps-relieve-pressure.
“Cervical Laminectomy and Fusion.” How Much Does a Cervical Laminectomy and Fusion Cost? What Is a Cervical Laminectomy and Fusion? – MDsave. Accessed May 03, 2018. https://www.mdsave.com/procedures/cervical-laminectomy-and-fusion/d482fdcc.
“Cervical Laminectomy Spine Treatment | Neurosurgery.” Precision Brain, Spine & Pain Centre. Accessed May 03, 2018. https://www.precisionhealth.com.au/healthcare-services/advanced-neurosurgery-spinal-surgery/procedures-and-surgery/cervical-laminectomy/.