Cervical decompression surgery

Cervical decompression surgery

Cervical decompression surgery is a procedure that removes any structures compressing the nerves in the cervical (neck) section of the spinal canal or vertebral foramen (the opening through which the spinal cord passes). The cervical section of the spine begins at the base of the skull and supports the neck. During surgery, a small section of the bone that is compressing the nerve root is removed to alleviate pressure and allow the nerve root to heal. Sometimes fragments of material from the spine are lodged under the nerve root as well, and are removed during cervical decompression surgery.
 
If too much of the bony structures that are pressing on the nerve needs to be removed, it can affect the stability of the spine. In such cases, cervical decompression surgery must be combined with cervical fusion surgery. Spinal fusion corrects the instability by permanently joining (fusing) the vertebrae together to prevent them from moving. If the cervical decompression surgery is minimally invasive, the structure of the spine will stay intact and there will be no need for spinal fusion.
 
Cervical spinal stenosis is one of the most common reasons for cervical decompression surgery. Cervical spinal stenosis is a condition in which the spinal canal and/or the opening in the vertebra (vertebral foramen) in the neck become narrowed. If the narrowing is substantial it can cause nerve compression and result in pain, loss of balance and coordination, neck stiffness and incontinence

Nonsurgical treatment

Before recommending carpal tunnel surgery, your doctor will most likely suggest other carpal tunnel treatments or exercises to relieve any swelling, pressure or pain. Treatments can include:

  • Rest – Initial treatment usually consists of resting your hand and wrist while immobilizing your wrist in a splint for at least two weeks. You should also avoid activities that can further irritate the affected areas.
  • Splint – Wearing a splint that holds your wrist in a neutral or straight out position at night is usually the most effective treatment to control carpal tunnel symptoms, especially the numbness, tingling and pain that occur at night or when waking up in the morning. Many patients can avoid surgery by using just this simple treatment alone.
  • Anti-inflammatory drugs – Aspirin, ibuprofen and other nonprescription painkillers can ease the pain.
  • Steroid injections – These treatments ease swelling and pressure on the median nerve.
  • Vitamin B6 – This vitamin has been reported to relieve some symptoms of carpal tunnel syndrome.
  • Exercise – Stretching and strengthening exercises can be helpful if your symptoms have significantly decreased. A physical therapist will sometimes oversee these exercises or can teach you how to perform them on your own.

Types of surgery

Most of the following procedures are performed with the goal of leaving the spinal structure intact. Once the compressive structures have been removed, your spine surgeon will evaluate the stability of your spine and determine whether cervical fusion surgery also is needed.

  • Foraminotomy – This surgery creates a bigger space in the foramen to relieve pressure on the compressed nerves. The foramen are openings in the vertebrae through which the nerve bundles pass to travel to different areas of your body. 
  • Laminotomy – Your spine surgeon creates a hole in the lamina (bone covering the spinal canal, the large hole in the center of the vertebra through which the spinal nerves pass) to make more space and to relieve pressure on the nerves.
  • Laminoplasty – Two incisions are made on both sides of the lamina to relieve neural pressure. This creates a hinge on one side and a small hole on the other side of the lamina. A spacer made out of bone, metal or plastic is inserted to hold the spinal canal open.
  • Corpectomy – This procedure is performed when cervical stenosis (narrowing of the spinal canal) affects more than one disc. The surgeon removes the vertebral body as well as the affected discs to relieve pressure.
  • Microdiscectomy – Also called microdecompression, this minimally invasive surgery is performed through a small incision in the neck. The spine surgeon removes a small section of the bone over the nerve root. During this procedure, disc material under the nerve root may be removed as well. A microdiscectomy aims to relieve nerve compression and allow the nerve to heal.
  • Cervical laminectomy – This is the most common surgery for cervical spinal stenosis. The spine surgeon removes a small section of the lamina to relieve compression on the nerve. The remaining spinal bones are connected back together with titanium metal rods and screws.

After surgery you can expect your hospital stay to last up to seven days. Full recovery from cervical decompression surgery can take an average of five weeks.

The multidisciplinary team of spine experts at Northwell Health Orthopaedic Institute performs cervical decompression surgery as well as a broad range of other surgeries for conditions that affect the spine.

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