Once a good position is managed, the shoulders are strapped. The head of the patient is usually fixed to the table by the use of tongs (pins). Once everything is in place, the patient is turned onto his belly on the operating table. The neurological monitoring checks sensory as well as motor functions. Neurologic monitoring is also used to check the patient’s neurological status during the surgery. The anesthesia team puts the patient onto multiple monitoring systems. A tube is passed into the windpipe to control respiration and breathing. The patient is taken to the operating room where general anesthesia is used. All relevant clearances from all the needed specialties as well as the anesthesia team are taken. A thorough discussion with the patient is done before the surgery with regards to expectations and results. It is a major spine surgery, which requires meticulous preparation and skills and instrumentation of the highest quality to carry it out. Posterior laminectomy and posterior cervical fusion are done from the back of the neck. For patients who are deteriorating neurological status, surgery is the only good option to halt the progression and possibly allow recovery of the neurological status. Patients with a small canal, which can be there since birth is at a higher risk of this disease process. Multilevel compression of the spinal cord due to arthritic changes is the most common indication for this surgery. If the surgery involves multiple levels then surgery from the back is a good option to take care of the disease. Patients who deteriorate over time can only be treated by surgical options in an attempt to stop the progression and allow recovery. Patients with such a presentation may either stay stable or deteriorate. It may also be associated with gait problems due to imbalance and bowel and bladder issues. It may be associated with tingling and numbness. CSM is defined as arthritic changes on the neck due to the ossification of the ligaments or disc disease, which causes compression of the spinal cord leading to changes in the neurological status of a patient.ĬSM usually presents with weakness in the upper extremity only or in all four extremities. The most common and widely used indication for laminectomy and posterior cervical fusion is cervical spondylotic myelopathy (CSM). If the disease is localized and can be taken care of from the front, then surgery from the front is preferred.Ĭervical Spine X-ray in Lateral view. As it is a fusion surgery, it also leads to more stiffness, but the patients who usually need this surgery are already stiff and have pathology or disease, which can be properly taken care of from the surgery from the back of the neck only. Posterior cervical fusion and laminectomy is usually performed over 4 to 6 segments depending on the need. The surgery of posterior cervical fusion and laminectomy is usually performed on a long segment covering almost 50-70% of the neck as compared to the surgery from the front, which includes anterior cervical discectomy and fusion (ACDF) and Total disc replacement (TDR) and is done at shorter levels of 1 to 3 levels only. Posterior cervical fusion provides stability to the neck after laminectomy, to avoid late failures, which can be disastrous. Laminectomy in itself is bound to fail by causing instability of the neck. Laminectomy is performed to remove the pressure from the spinal cord and possibly nerve roots if needed. ![]() Laminectomy means removing the bone and the tissue from the back of the spinal cord in the neck. This surgery is usually performed in conjunction with laminectomy. Posterior cervical fusion means operating the neck from the back and doing a fusion surgery so as to stabilize the neck.
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