Our Summary

This research investigated the effect of changes in the curve of the neck on the movement of the spinal cord and the success of a certain type of neck surgery called Laminectomy with Lateral Mass Screw Fixation (LCSF). This surgery is often used to treat a condition called cervical spondylotic myelopathy (CSM), which involves the compression of the spinal cord in the neck.

The researchers looked at 78 patients who had normal neck curvature before their LCSF surgery. Six months after surgery, they divided these patients into two groups: those whose necks had become less curved after surgery and those whose necks had stayed normally curved.

They found that patients with less curved necks had less movement in their spinal cords. They also found that these patients had worse neck symptoms but that their overall neurological recovery was not affected, and the incidence of a specific nerve injury called C5 palsy was not different from the group with normal neck curvature.

In conclusion, more than half of the patients lost some of their neck curvature after LCSF surgery. While this resulted in less movement of the spinal cord and worse neck symptoms, it did not affect the overall neurological recovery or likelihood of C5 palsy.

FAQs

  1. What is Laminectomy with Lateral Mass Screw Fixation (LCSF) surgery used to treat?
  2. How does a change in neck curvature after LCSF surgery affect the movement of the spinal cord and neck symptoms?
  3. Does the loss of neck curvature after LCSF surgery affect the overall neurological recovery or the likelihood of C5 palsy?

Doctor’s Tip

A doctor might advise a patient undergoing spinal laminectomy to follow post-operative instructions carefully, including maintaining proper posture and avoiding activities that may strain the neck. They may also recommend physical therapy to help improve neck curvature and prevent complications. Additionally, patients should communicate any changes in symptoms or concerns with their doctor to ensure proper recovery and healing.

Suitable For

Patients with cervical spondylotic myelopathy (CSM) who experience compression of the spinal cord in the neck are typically recommended spinal laminectomy with lateral mass screw fixation (LCSF) surgery. This surgery is often recommended for patients with severe neck pain, weakness, numbness, or tingling in the arms and hands, and difficulty with fine motor skills.

Additionally, patients with spinal stenosis, degenerative disc disease, herniated discs, or other spinal conditions that cause compression of the spinal cord may also be recommended for spinal laminectomy surgery. Patients who have not responded to conservative treatments such as physical therapy, medications, or injections may be candidates for spinal laminectomy surgery to relieve pressure on the spinal cord and nerves.

It is important for patients to consult with a spine specialist to determine if spinal laminectomy surgery is the best treatment option for their specific condition and symptoms.

Timeline

Timeline of patient experiences before and after spinal laminectomy:

Before surgery:

  • Patient experiences symptoms of cervical spondylotic myelopathy, such as neck pain, numbness or weakness in the arms or hands, and difficulty walking.
  • Patient undergoes diagnostic tests, such as MRI or CT scans, to confirm the diagnosis of CSM.
  • Patient consults with a neurosurgeon or orthopedic surgeon to discuss treatment options, including spinal laminectomy.
  • Surgery is scheduled and patient undergoes pre-operative preparations, such as blood tests and imaging studies.

After surgery:

  • Patient undergoes spinal laminectomy with LCSF to decompress the spinal cord and stabilize the spine.
  • Patient may experience pain and discomfort in the neck and back immediately after surgery.
  • Patient is monitored in the hospital for a few days to ensure proper healing and recovery.
  • Patient undergoes physical therapy and rehabilitation to regain strength and mobility in the neck and upper extremities.
  • Patient follows up with the surgeon for post-operative appointments to monitor progress and address any concerns.
  • Patient may experience improvement in symptoms, such as reduced neck pain and improved arm and hand function, over time.
  • Patient continues with long-term follow-up care to monitor for any potential complications or recurrence of symptoms.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal laminectomy include:

  1. What is the purpose of the surgery and how will it help alleviate my symptoms?
  2. What are the potential risks and complications associated with spinal laminectomy?
  3. How long is the recovery process and what can I expect in terms of post-operative pain and mobility?
  4. Will I need physical therapy or rehabilitation after the surgery?
  5. What are the chances of developing complications such as C5 palsy?
  6. How will the surgery affect the curvature of my neck and what impact could this have on my spinal cord movement?
  7. Are there any alternative treatment options available for my condition?
  8. What is the success rate of spinal laminectomy for patients with similar conditions to mine?
  9. How long do the effects of the surgery typically last?
  10. Are there any lifestyle changes or precautions I should take after the surgery to promote healing and prevent complications?

Reference

Authors: Hou SB, Sun XZ, Liu FY, Gong R, Zhao ZQ, Lu K, Liu YB. Journal: J Neurol Surg A Cent Eur Neurosurg. 2022 Mar;83(2):129-134. doi: 10.1055/s-0041-1723807. Epub 2021 Oct 11. PMID: 34634827