What Is Cervical Decompression?
Cervical decompression is a surgical procedure aimed at relieving pressure on the cervical nerve roots exiting the spinal column or on the spinal cord itself. This can help relieve neck pain and other nerve-related symptoms that have not responded well to conservative therapy.
Usually, a surgeon approaches a cervical decompression by entering the spinal column from the front, known as an anterior cervical decompression. This involves making an incision in the front of the neck. Some cases, however, require entering through the back of the neck, or posteriorly. This may be the best option if a disc has herniated laterally (to the side) or if nerves are being compressed by structures at the back of the cervical spinal column. One advantage is that posterior cervical decompressions do not always require fusion surgery, thus reducing the time necessary to heal. However, it can result in more tissue trauma and cause more operative pain than the anterior approach.
To perform a posterior cervical decompression, the surgeon makes an incision along the mid-portion of the back of the neck. During this procedure, the patient’s head is held in a clamp. This immobilizes the head and prevents pressure on the spinal cord as a result of repositioning during surgery.
With the incision made, the surgeon carefully cuts through the muscle to expose the vertebrae in the cervical spine. If necessary, the surgeon may remove the lamina, (plates of bone found on the back of the vertebrae) to make more room for the spinal cord. This is called a cervical laminectomy. Alternatively, he may hinge the lamina and create a larger canal for the nerves to pass through by using metal plates and screws. This is called a cervical laminoplasty. Both of these procedures reduce pressure on nerves in the spinal column.
The ligaments within the spinal canal may also be removed if they are pressing against nerve roots or the spinal cord. Furthermore, the foramen or opening through which the nerve root passes may be enlarged to create more space for the nerve roots to leave the spinal column. This is called a cervical foraminotomy.
Though serious complications as a result of posterior cervical decompression are uncommon, they may include bleeding, infection, or nerve and spinal cord damage. On rare occasions, fluid may leak from the dura (the membrane surrounding the spinal cord).
The possibility also exists of experiencing continued pain despite the surgery. Plus, as with all surgeries, there can be complications from the anesthesia. Post-surgical instability (abnormal motion of the bones) is more common after posterior cervical decompression than anterior cervical decompression.
Healing after a posterior cervical decompression is often more painful than after an anterior cervical decompression, due to the thick layer of muscle in the back of the neck that had to be mobilized to reach the spine. Serious complications, however, are rare.
Tom Wascher M.D. will review your imaging studies free of charge or, if needed, provide you with a second opinion. He has performed over 1,800 cervical surgeries during his career and wants to see that you receive the best treatment possible. He is a competent and caring surgeon who has your best interests in mind.