This operation is used to relieve compression on the spinal cord and nerve roots. Typically, decompression is recommended from an anterior approach (ACDF), but in some circumstances a posterior operation is required. This is sometimes recommended to be performed in combination with an anterior operation. This operation can be recommended for patients who have a narrow spinal canal, kyphotic (bent forward) alignment of the cervical spine, compression coming from the posterior aspect of the spinal canal, or problems associated with 4 or more levels.
The options for surgical decompression from a posterior approach include:
You will be placed face down onto an operating table with a specialised head holding device. The bottom of the hairline is often needed to be shaved to ensure a clean area for the operation and reduce the risk of infection. After carefully checking the correct spinal level, an incision is made on the back of the neck, and the spinous processes are found. The muscle is then elevated from the lamina to reveal the posterior bony aspects of the cervical spine.
Depending on the planned operation, the level is again checked and then the bone is either cut or removed to allow complete decompression of the area that is planned to be addressed. If fusion is required then screws and rods are placed along with bone graft. If laminoplasty is required then the bone is expanded and specialised plates are placed to hold the bone in its new position.
The wound is closed with dissolvable sutures. There will be a surgical drain to prevent post-operative haematoma. You will have a soft cervical collar applied.
You will be taken to the recovery room and monitored until safe. Once back on the surgical ward, you will be given food and drink when you are comfortable and will be seen by a physiotherapist to begin slowly walking. A post-operative scan will be performed the following day to check the alignment of the spine and position of any implants that were inserted.
You can go home if comfortable after 2 or 3 nights in hospital. Some patients will need a period of inpatient rehabilitation. You should not drive or do any heavy lifting for at least 6 weeks after surgery. Dr Anderson will discuss return to these activities with you at your post-operative appointments.
While generally safe, there are risks associated with any surgical procedure. Specific to this operation, the risks include, but are not limited to:
Dr Anderson will discuss these with you during your consultation, as well as any other specific questions that you may have about the procedure.