Name of the Procedure:

Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical

Summary

A cervical laminectomy is a surgical procedure that involves removing parts of the vertebrae in the neck (cervical) region to access and remove or evacuate an intraspinal lesion that is located outside the spinal cord but within the spinal column. This procedure does not involve removing tumors (neoplasms).

Purpose

This procedure addresses conditions where lesions or abnormal growths cause compression of the spinal cord or nerves in the cervical spine. The goal is to relieve pressure, reduce pain or discomfort, and prevent further neurological damage.

Indications

• Persistent neck pain not relieved by conservative treatments
• Radiating pain, numbness, or weakness in arms and hands
• Confirmed extradural lesion through imaging studies
• Symptoms of spinal cord compression such as difficulty walking or coordination issues

Preparation

• Patients may need to fast for several hours before surgery.
• Certain medications might need to be adjusted or stopped.
• Preoperative imaging tests such as MRI or CT scans are necessary to locate and evaluate the lesion.

Procedure Description

1. The patient is administered general anesthesia.
2. A small incision is made in the back of the neck.
3. Muscles and soft tissues are moved aside to expose the vertebrae.
4. A portion of the vertebra (lamina) is removed to create an access window.
5. The lesion is then identified and carefully excised or evacuated.
6. The incision is closed with sutures or staples, and a sterile bandage is applied.

Duration

The procedure typically takes 2 to 4 hours.

Setting

This surgery is performed in a hospital operating room.

Personnel

• Neurosurgeon or orthopedic spine surgeon
• Anesthesiologist
• Surgical nurses and technicians

Risks and Complications

• Infection
• Excessive bleeding
• Spinal fluid leakage
• Nerve damage or neurological deficits
• Postoperative pain
• Possible need for additional surgeries

Benefits

• Relief from pain and discomfort
• Improved mobility and functionality
• Reduced risk of further neurological damage
• Enhanced quality of life

Recovery

• Patients may need to stay in the hospital for 1-2 days.
• Pain management with prescribed medications.
• Instructions on wound care and activity limitations.
• Physical therapy may be recommended.
• Follow-up appointments to monitor recovery.

Alternatives

• Conservative treatments like physical therapy, medications, or injections
• Minimally invasive spine surgeries
• Anterior cervical discectomy and fusion (ACDF) for certain conditions

Pros and cons of alternatives:

• Conservative treatments are less invasive but may not provide sufficient relief.
• Minimally invasive options have shorter recovery times but are not suitable for all lesion types or locations.

Patient Experience

During the procedure:

• The patient will be under general anesthesia and unconscious.
• No pain will be felt during the surgery.

After the procedure:

• There may be a moderate amount of pain or discomfort that is usually managed with medications.
• Patients may feel some stiffness or limited mobility in the neck initially.
• Gradual improvement as healing progresses, with proper post-operative care and physical therapy.