Our Summary

The researchers conducted a study comparing two types of surgical procedures used to treat degenerative cervical myelopathy (a condition that affects the neck, causing stiffness, pain and other issues). One procedure was a stand-alone dorsal laminectomy (a type of spine surgery), either with or without an additional fusion (a process of joining two or more vertebrae).

They found that the group that had the laminectomy surgery without the fusion had a slightly greater decrease in the curvature of their neck (about 6 degrees) five years after the surgery. However, this did not have any significant impact on their neck disability or their overall quality of life.

In simpler terms, the study suggests that for well-selected patients, especially those who need surgery on fewer than three levels of the spine, having a laminectomy without a fusion can lead to a small change in the shape of the neck, but it doesn’t really affect the patient’s recovery or quality of life.

FAQs

  1. What is the difference between a stand-alone dorsal laminectomy and one with a fusion?
  2. What were the findings of the study regarding the impact of laminectomy without fusion on neck curvature and quality of life?
  3. Who are the well-selected patients that the study suggests might benefit from having a laminectomy without a fusion?

Doctor’s Tip

A helpful tip a doctor might give a patient about spinal laminectomy is to follow post-operative instructions carefully, including physical therapy and rehabilitation exercises, to ensure a successful recovery and to minimize the risk of complications. It is important to communicate any changes or concerns with your doctor and to attend all follow-up appointments to monitor progress and address any issues that may arise.

Suitable For

Patients who are typically recommended spinal laminectomy are those who have degenerative cervical myelopathy, spinal stenosis, herniated discs, or other conditions that cause pressure on the spinal cord. These patients may be experiencing symptoms such as neck pain, stiffness, weakness, numbness, or tingling in the arms or legs. Patients who have not responded well to conservative treatments such as physical therapy, medications, or injections may be candidates for spinal laminectomy surgery. Additionally, patients with progressive neurological symptoms or those who have difficulty walking or performing daily activities may also be recommended for spinal laminectomy.

Timeline

Before the spinal laminectomy:

  • Patient experiences symptoms of degenerative cervical myelopathy, such as neck stiffness and pain
  • Patient undergoes diagnostic tests, consultations with healthcare providers, and possibly conservative treatments like physical therapy or medications
  • Decision is made to undergo spinal laminectomy surgery

After the spinal laminectomy:

  • Patient undergoes the surgical procedure, which involves removing part of the lamina (the bony structure that covers the spinal cord) to relieve pressure on the spinal cord
  • Patient may experience pain and discomfort in the immediate post-operative period
  • Patient undergoes rehabilitation and physical therapy to regain strength and mobility
  • Patient gradually improves over time, with some potential changes in neck curvature
  • Patient’s overall quality of life and function are assessed over the long term to determine the effectiveness of the surgery.

What to Ask Your Doctor

  1. What is a spinal laminectomy and how does it differ from other spinal surgeries?
  2. What are the potential risks and complications associated with a spinal laminectomy procedure?
  3. How long is the recovery process after a spinal laminectomy surgery?
  4. Will I need physical therapy or rehabilitation after the surgery?
  5. Are there any specific restrictions or limitations I should follow post-surgery?
  6. How long can I expect the benefits of the surgery to last?
  7. Will I need any additional procedures or treatments in the future?
  8. What are the chances of experiencing a recurrence of symptoms after the surgery?
  9. How experienced are you in performing spinal laminectomy surgeries?
  10. Are there any alternative treatment options to consider before undergoing a spinal laminectomy?

Reference

Authors: Jentzsch T, Wetzel OT, Malhotra AK, Lozano CS, Massicotte EM, Spirig JM, Fehlings MG, Farshad M. Journal: Eur Spine J. 2024 Aug;33(8):3109-3116. doi: 10.1007/s00586-024-08260-3. Epub 2024 Jun 2. PMID: 38825607