Posterior Cervical Laminectomy / Laminoplasty

Operation
Cervical Laminectomy/Laminoplasty, +/- foraminotomy

Indication
Cervical myelopathy(weakness and balance disturbance) due to spinal cord compression, multilevel compressive radiculopathy

Pre-assessment
Required

Special preparation for surgery
Imaging of area, MRI +/- CT scan
Stop all blood thinning medications including aspirin, warfarin, clopidogrel.
Stop HRT and oral contraceptives. Stop some herbal medicines.
You will be advised when to stop these medications.

Admission to hospital
On day of surgery

General anesthetic
Yes

Operation position
Patient lies prone (face down) on a special spinal table and wears a Mayfield skull traction holding system

Details of operation
A midline incision is made at the back of the neck. Dissection is achieved to expose the bones of the posterior arch of cervical vertebrae to be decompressed. For the laminectomy the lamina and spinous processes are removed, for the laminoplasty, the lamina are elevated away from the spinal canal. Fusion is performed using lateral mass screws and rods if there is potential cervical instability.

Length of surgery
2hrs

Urinary catheter required
Yes

Post-operative drain required
Occasionally

Post-operative antibiotics
Yes

Post-operative iv fluids (drip)
Yes

DVT prophylaxis
Yes

Mobilization after surgery
Next day

Length of stay in hospital
Three days

Post hospital recovery
2 weeks of gentle rest followed by 2 weeks gradually increasing to normal daily activities and a further 2 weeks of increasing to full activity level. Leave strenuous activities until after 6 weeks.

Sutures removed
Dissolvable

Dressing
Glue dressings

Review appointment
6 weeks

Physiotherapy
Yes

Return to driving
6 weeks

Return to work
8-12 weeks