A cervical laminectomy is surgery through the back of the neck that removes the bony roof (lamina) of one or more vertebrae to take pressure off the spinal cord or nerves. It is often combined with a fusion. A laminoplasty hinges the roof open instead of removing it. Most people stay in the hospital 2 to 4 days. Preparing well means planning for several weeks of help, a home that is safe to walk around, and a long, gradual recovery.
These operations are usually done for spinal cord compression across several levels (cervical myelopathy), which causes clumsy hands, numbness in both hands and unsteady walking. Because the cord can be slow to recover, the main aim of surgery is usually to stop symptoms getting worse. Your surgeon’s protocol comes first. If their instructions differ from anything here, use theirs.
Key takeaways
- What it does: makes more room for the spinal cord by removing or hinging open the bony roof at the back of the neck.
- Main aim: when done for spinal cord compression, to stop symptoms getting worse; improvement is a hoped-for second gain.
- Hospital stay: often 2 to 4 days, longer after a fusion or several levels.
- Early recovery: back-of-neck muscle pain is common for 2 to 3 months.
- Falls: balance is often already affected, so a safe home matters before surgery.
What the operation does
- The approach: a cut down the middle of the back of the neck. The muscles are moved aside to reach the bone, which is why the back of the neck is sore afterward.
- Laminectomy: the lamina is removed at one or more levels. When several levels are removed, a fusion with rods and screws is often added to keep the neck from slowly curving forward.
- Laminoplasty: the lamina is cut on one side, hinged open on the other and held open with small plates. The canal is wider and the neck keeps more movement than after a fusion.
- Choosing between them: your surgeon weighs the shape of your neck, how many levels are involved, and whether there is instability or neck pain.
What to set up at home
- Help: someone with you for at least the first week, and help with shopping, cleaning and heavier jobs for 4 to 6 weeks or longer.
- Falls: remove loose rugs and cables, light hallways at night, and keep the route from bed to bathroom clear. Grab bars by the toilet and in the shower, and a shower chair, are worth fitting before surgery.
- Stairs: if stairs are hard now, consider setting up to live on one floor for the first weeks.
- Hands: if buttons and zippers are already difficult, choose pull-on tops with wide necks, elastic waists and slip-on shoes. Lever faucets and pump bottles help.
- Kitchen: daily items between waist and shoulder height. Ready-made meals for the first two weeks.
- Sleeping: a pillow that supports the neck on your back and side. Some people find a recliner easier at first.
- Driving: arrange rides for about 4 to 8 weeks.
What to practice before surgery
- Getting out of bed: roll to your side, lower your legs, push up with your arms, keeping the head in line with the body.
- The collar: if one is planned, ask to be fitted and shown how to put it on and take it off before the operation.
- Walking aid: if a cane or walker is suggested, practice with it now, on level ground and on any steps at home.
- A baseline: note how long buttons take, how far you can walk and whether you need the rail on stairs. It helps you and your PT see change over months.
- Gentle exercise: any walking, balance or hand exercises your surgeon or PT allows before surgery.
Write down what your hands and walking can do now. It is the yardstick you will measure the next year against.
Questions to ask your surgeon
- Are you planning a laminectomy, a laminectomy with fusion, or a laminoplasty, and why for me?
- How many levels, and which ones?
- Which of my symptoms do you expect to stop getting worse, and which might improve?
- Will I need a collar, and for how long?
- What are the lifting limits, and when can I drive?
- What are the signs of C5 nerve weakness, and what should I do if I notice them?
- Which medicines should I stop or continue before surgery?
- When does physical therapy start, and will it include balance and hand work?
The first 48 hours
You wake with a dressing down the back of the neck and possibly a drain. The back of the neck is sore and stiff, and pain relief is given on a schedule. Nurses check the strength and feeling in your arms and legs often. A physical therapist usually helps you sit up, stand and walk within the first day or two.
Lying on your back can press on the wound at first. Many people prefer lying on their side with a pillow that keeps the neck level.
Call your surgeon or emergency number if
- New weakness: sudden new weakness or numbness in the arms or legs, or walking that suddenly gets much worse. Call your local emergency number.
- Bladder or bowel: new loss of control, or you cannot pass urine. Call your local emergency number.
- Breathing or swallowing: difficult or noisy breathing, or you cannot swallow sips of water. Call your local emergency number.
- Neck swelling: swelling around the wound or neck that grows quickly.
- Voice changes: a hoarse or weak voice that is getting worse.
- Shoulder weakness: new difficulty lifting one or both arms to the side.
- Wound or fever: spreading redness, discharge, a bad smell, the wound opening, or a fever of 100.4°F (38°C) or higher.
- Calf or chest: one calf swollen and painful, or sudden breathlessness or chest pain.
More on this area: surgery recovery guides.
Make the home safe to walk around, line up help for the first month, and measure the recovery in months.
Written by Louise Yow, Neck & Shoulder Physio.