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Cervical laminaplasty is a surgical procedure to open the spinal canal and relieve pressure on the spinal cord and spinal nerves to relieve shoulder and arm pain, numbness or weakness. The surgery is performed through an incision in the back of the neck. The bony arches that form the “roof” of the spinal canal are hinged open from one side, increasing the dimensions of the spinal canal and creating more room for the spinal cord.
If You Have Decided to Have Surgery:
- Call Dr. Jeffords’ staff to schedule your surgery date and the date for your pre-operative consultation.
- At your pre-operative consultation Dr. Jeffords or his P.A. will discuss the procedure with you, answer any questions you may have, and have you sign a consent form for surgery.
- You will be given prescriptions for pain medicine and instructions for post-operative care.
- Your pre-operative evaluation at the hospital will be scheduled on the same day as your pre-operative consultation. You will have a chest X-ray, EKG, and blood-work performed.
- If you take aspirin or anti-inflammatory medications daily, STOP these medications at least 7 days before your surgery.
- If you are a smoker you should make every effort to stop smoking as soon as you can before surgery (at least 2 weeks prior to surgery). You should not smoke for at least 6 weeks after surgery.
- You will check into the hospital the morning of surgery.
- Your anesthesiologist will bring you to the operating room and put you to sleep for the operation.
- There are usually two nurses in the room and a surgical assistant that assists Dr. Jeffords with the operation.
- You will be positioned lying on your stomach, face-down. An incision is made in the back of your neck.
- After carefully moving the muscle tissue to the sides, a retractor is placed to expose the back of the spine.
- One one side of the spine, the lamina (bony arches) are cut where they meet the facet joints.
- On the other side, a bur is used to create a narrow groove in the bone, thinning the bone to the point where it becomes flexible. This allows the bone on that side to act as a hinge, and the arches can be opened, relieving the pressure on the spinal cord.
- The arches are held open with small bone grafts that are secured with tiny titanium plates and screws.
- A drainage tube may be placed under the muscles before closing the incision to keep any blood or drainage from collecting beneath the incision. This is usually removed on the 1st or 2nd day after surgery depending on the amount of drainage.
- The incision is closed with resorbable stitches that are placed beneath the skin.
- The surgery will take approximately 2–3 hours.
- You will be taken to the recovery room (PACU) and stay there for about 1-1 ½ hours. Afterwards you will be taken to your hospital room where you can visit with your family.
- Dr. Jeffords will speak to your family while you are in the recovery room.
- You will be given a PCA pain-pump which is a machine that you are able to control to help alleviate any post-surgical pain. The following morning you will be switched from the PCA to oral pain pills.
- The nurses will get you out of bed shortly after surgery and the physical therapists will work with you to ensure that you are strong enough to walk and climb stairs.
- The surgical dressing will be changed and the small drain removed either the 1st or 2nd morning after surgery. This dressing will stay on until you see Dr. Jeffords in the office two weeks after surgery. You may shower over the dressing.
- The hospital stay is usually 1-3 days depending on the number of levels operated on.
- You will be able to ride in a car or plane upon leaving the hospital.
After Going Home:
- You will be given pain medication and a muscle relaxant to help control post-operative pain and spasms. Make sure you do not drive or operate heavy machinery while on the medication.
- You will wear a soft neck brace for two weeks after surgery.
- You may begin driving at 2 weeks.
- You can expect to return to sedentary office or desk-work approximately 2 weeks after surgery.
- If you perform manual labor that requires heavy lifting you should wait 3 months before returning to this activity. You can return to moderate duty at 4-6 weeks.
- Sports activities such as running, golf, or tennis may be resumed at 3 months.
Potential Risks and Complications:
- Nerve root damage (0.5-1%)
- Tear of the nerve sac (“dural tear”) with leakage of spinal fluid (1-3%). Usually recognized during the procedure and repaired, causing no change in the outcome of surgery. Occasionally recognized after surgery requiring a period of laying flat to allow the tear to heal, or possible surgery to repair the tear.
- Infection (1-2%)
- Bleeding requiring a blood transfusion
- Medical complications such as heart attack, stroke, blood clots, and pneumonia. Risk is dependant on the patient’s medical condition and age.