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Cervical Laminotomy and Disectomy

What is a Cervical Laminotomy and Discectomy?

A cervical laminotomy and discectomy is a surgery done from the back of the neck. Once the neck muscles are pushed over to the side, a piece of the lamina bone is removed. When the nerve and disc is seen, a portion of the disc is removed until the spinal nerve is free of pressure from the disc.

Why as a Cervical Laminotomy and Discectomy done?

A cervical laminotomy and discectomy is done to free up a spinal nerve which is compressed or irritated by a disc herniation in the neck.

  1. An intravenous catheter is started and antibiotics are given.
  2. This surgery is done in an Operating Room.
  3. The patient is placed under General Anesthesia while lying on their back (supine)
  4. The patient is then carefully placed on their stomach (prone) on the operating table.
  5. The head and neck are carefully positioned to make the approach for surgery as good as possible.
  6. The back of the neck is now cleaned with a surgical antiseptic and plastic covers (drapes) are placed around the area where the surgery will take place.
  7. The surgeon then makes the initial cut (incision) in the center of the spine.
  8. The softer tissues (fat, fascia) are then separated with a cautery until the tips of the spinous processes (tips of the spine) are seen.
  9. The muscle attachments to the back of the vertebra are then carefully removed and the muscles pulled off to the sides with retractors (metal devices to help see deeper structures).
  10. Often X-Rays are taken to make sure the surgeon knows this is the correct level in the spine.
  11. The lamina is now clearly visible and often thinned using a burr (similar to dentist’s drill).
  12. Once the lamina is quite thin, it is carefully removed with very delicate, small instruments until the spinal nerve can be seen.
  13. The nerve is carefully inspected and any disc material is removed until it is completely freed up.
  14. The main part of the surgery is now complete.
  15. The retractors are removed and the muscles allowed to fall back over the area where the surgery took place.
  16. The muscles are usually stitched (sutured) back together.
  17. The skin is closed, often with small surgical staples.
  18. A bandage (dressing) is placed over the wound.
  19. Often, a brace is put on the neck to protect the area from movement.
  20. The patients is carefully rolled back on their back (supine) and awoken from Anesthesia.
  21. The patient is then brought to the Recovery Room.

How long does a surgery like this take?

The surgery typically takes 1-2 hours to complete for one spinal level.

What is the recovery from a Cervical Laminotomy and Discectomy like?

  1. The patient is admitted to the hospital usually just overnight.
  2. A neck brace will often stay in place for a short period of time.
  3. The surgeon may restrict the amount of motion in the neck for a short period of time.
  4. The surgeon will evaluate the patient and take more X-Rays within a few weeks after surgery.
  5. The restrictions on movement are lifted as healing occurs.
  6. The patient is often evaluated by the surgeon within several weeks. The wound typically heals over 2-4 weeks.
  7. The symptoms (pain, numbness, weakness) from the spinal nerve inflammation often improve quickly, but could take several months to reach the maximum level of improvement as the nerve heals.

What type of benefit can patients gain from a Cervical Laminotomy and Discectomy?

The symptoms from nerve compression such as tingling, numbness and pain in the arm often improve quickly. However it may take weeks to months for the maximum improvement to take place. Depending on how long and how severe the nerve compression was, the recovery can be partial or complete.