A cervical laminectomy is a surgical procedure to remove the back of one of the vertebra in the spine at the neck, usually to relieve pressure on a nerve caused by stenosis, or narrowing, of the spinal canal. Bone spurs and ligaments that are pressing on nerves may be removed during the same procedure.
Usually this narrowing occurs between the fifth and sixth cervical vertebrae or the sixth and seventh cervical vertebrae. Spinal stenosis can be static, usually the result of years of wear and tear, especially in people who do underwater diving or lots of lifting. It can also be dynamic, caused by bone spurs or deformities in the disk that cause narrowing of the spinal canal during motion but not at rest.
Most people who have cervical laminectomy suffer moderate severe loss of range of motion due to spinal stenosis. Untreated, spinal stenosis can cause spastic paresis (muscle spasms with loss of strength primarily in the muscles of the legs) or quadriparesis (loss of strength in muscles in both the arms and legs).
Doctors typically advise their patients that after they have the surgery they may have to wear a neck collar for a few weeks and they won't be able to lift more than about 10 pounds (4-5 kilograms, or the weight of a gallon of milk) for four to six weeks. More often than not, these optimistic predictions turn out to be right, but time and time again, a significant percentage of patients who go ahead and have the surgery find the doctor's estimates of recovery time to be wildly optimistic. Some people have complete relief from pain and return to normal activities in just a few weeks. Some people get no relief from pain and have serious complications years after the surgery. What makes the difference in outcomes?
- Spinal fusion with laminectomy greatly increases recovery time.
- Spinal surgery causes severe pain that requires strong pain medication, usually opiates. Take the pain medication your doctor prescribes exactly as your doctor prescribes it. You don't want to get into a situation in which you need more and more opiates to control your pain. On the other hand, you don't want to turn down pain medication that you actually need. Pain itself slows down your recovery.
- Follow your doctor's orders regarding bending, stooping, and lifting objects after surgery. You can't recover if you keep reinjuring the tissues injured during the surgery.
- Constipation also slows down recovery from laminectomy surgery. Straining at stool isn't just painful, it can injure your neck. Opiates and inactivity reduce the frequency of bowel movement. As soon as you can control your pain with something like Tylenol, get off opiate drugs. Be sure you eat your vegetables and fruit every day, and take small amounts of soluble fiber with lots of water every day. Get up and walk as soon as you are able to help with bowel movement. Continue to get walking exercise every day after your doctor gives the OK. Don't use stimulant laxatives (like ExLax), because they can cause muscle spasms. Rely on fiber and extra fluid intake.
- Anesthesia can affect your sex life for several weeks after surgery. Both men and women can lose sensation in their sex organs even after a cervical laminectomy (although especially after a lumbar laminectomy). If you are sexually active, take it slow after your procedure so you don't have problems with muscle spasms or bleeding from your incision site.
- Silk pajamas make it easier to get in and out of bed. Some people use a trash bag to slip into position.
- A body pillow can help you find a comfortable sleeping position. A pillow under your knees can relieve tension on your back.
- Having the right amount of social support (for meals, rides, and housekeeping tasks) after your surgery can greatly improve your recovery.
And it's always good to be patient. Not everyone gets better at the same rate. It can take a long time to get over cervical laminectomy, but if you can avoid reinjuring yourself, it's almost always worth the effort.
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