Lumbar Laminectomy and Anterior Cervical Fusion

Lumbar laminectomy and anterior cervical fusion are surgeries that are done on the spine to relieve pressure on the spinal cord or one or more nerve roots.

LET YOUR HEALTH CARE PROVIDER KNOW ABOUT:

  • Any allergies you have.

  • All medicines you are taking, including vitamins, herbs, eyedrops, creams, and over-the-counter medicines.

  • Previous problems you or members of your family have had with the use of anesthetics.

  • Any blood disorders or blot clotting problems you have.

  • Previous surgeries you have had.

  • Medical conditions you have had.

RISKS AND COMPLICATIONS

Generally, this is a safe procedure. However, as with any procedure, complications can occur. Possible complications include:

  • Infection.

  • Bleeding.

  • Injury to surrounding structures.

  • Leakage of cerebrospinal fluid.

BEFORE THE PROCEDURE

  • Do not eat or drink for 6–8 hours before the procedure.

  • Take medicines as directed by your surgeon. Ask your surgeon about changing or stopping your regular medicines.

  • You will be given antibiotic medicines to keep the infection rate down.

  • The incision site on your neck will be marked.

  • Your neck will be cleaned to reduce the risk of infection.

PROCEDURE

For both procedures, you will be given medicine to make you sleep (general anesthetic). A breathing tube will be placed down your throat.

Lumbar Laminectomy

  • Your surgeon will make a 2 to 5-inch cut (incision) in your lower back (lumbar spine). The length of the incision will depend on how many spinal bones (vertebrae) are being repaired.

  • The muscles in your back are moved away from the vertebrae and are pulled to the side.

  • Pieces of the bony roof of the spinal canal (lamina) are removed. The lamina are removed to take the pressure off of the affected nerves.

  • The ligament that lies under the lamina and connects the vertebrae is removed. The remaining ligaments and a portion of the arthritic joints between the vertebrae are also removed (usually not completely) to take pressure off the nerves.

  • Once excessive tightness or pressure is removed from the nerves, no additional ligaments and bone are removed.

  • The back muscles are moved back into their normal position. The tissue under the skin is closed with absorbable, or dissolving, stitches. The skin is closed with stitches or staples.

  • A dressing is put over the incision.  

Anterior Cervical Fusion

  • An anterior cervical fusion means that the surgery is done through the front (anterior) part of your neck. The incision is usually within a skin fold line on your neck.

  • The neck muscles are pushed aside.

  • The surgeon will remove the affected, degenerated disk and bone spurs (decompression). This helps to take the pressure off the nerves and spinal cord.

  • The area where the disk was removed is then filled with a plastic spacer implant, bone graft, or both. These implants and bone grafts take the place of the disk and keep the nerve passageway open and clear for the nerves and spinal cord.

  • In most cases, the surgeon will put metal plates, pins, or screws (hardware) in the neck to help stabilize the surgical site and to keep the implants and bone grafts in place. The hardware reduces motion at the surgical site, so the bones can grow together. This provides extra support to the neck.

AFTER THE PROCEDURE

  • You will stay in a recovery area until the anesthesia has worn off. Your blood pressure and pulse will be checked often.

  • You may continue to receive fluids and medicines, such as antibiotics, through the IV tube for several days after the surgery.

  • You may need to wear a neck or back brace for several weeks after surgery, especially when up and out of bed.

  • You may be given pain medicine while still in the recovery area. Some pain is normal, but if your pain gets worse, tell your surgeon or nurse.

  • Be up and moving as soon as possible after surgery. Physical therapists will help you start walking.

  • To prevent blood clots in your legs:

  • You may be given compression stockings to wear.

  • You may need to take medicine to prevent clots.

  • You may be asked to do breathing exercises. This is to prevent a lung infection.

  • Most people stay in the hospital for 1–3 days after this surgery.